POWERFIN Job_Application

EMPLOYMENT APPLICATION

Name:
Address:		State: Zip:
Email Address:
Phone: Home	Cell:	Work:
In an Emergency, notify:		Phone:
Referred By :
Date of Birth:	City of Birth:	USA Citizen: YES / NO Can you present evidence of your USA citizenship? YES / NO
Driver License <> State Driver License #: Date Issued: Date Expires:
Have you ever been convicted for violation of any criminal offense? Y / N Date Convicted: If YES, please explain: ________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ If you need more spaces, please use spare paper.
Do you consider yourself medically fit & fully capable of crafting an aircraft propeller? Y / N
Any medical related items that may hinder training to safely process a hand-crafted product?
How were you referred to us:
Have you ever worked for us before?:Y / N
List present/past employees that you know:
Relationship to employees:
Hours available for work:: Are you wanting PART-TIME or FULL-TIME work?:
Can you work weekends? Y / N ….holidays? Y / N
Can you work evenings? Y / N Can you work overtime? Y / N Would you consider Summer ONLY work? Y / N

PLEASE READ & INITIAL EACH PARAGRAPH, then Sign below…

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or any document used in the consideration of employment, can be grounds for rejection of this application and immediate expulsion if employed.
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I understand that once employed, my employment is not definite and can be terminated at any time either with or without prior notice, by myself or the company.
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I permit the company to research my references, record of employment, education etc, that is listed on this application or with the documents that have accompanied or been provided with this application (resume, etc).
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I further authorize the references provided to disclose any information related to my character or employment or education, without giving me prior notice of such disclosure.
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In addition, I release the company, my former employers and all others listed with my employment application, from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
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Your comments or concerns…

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Signature of Applicant __________________________________________ Date _______/_______/________

Applicant’s printed name (First, Middle, Last) __________________________________________________________________

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This section will be completed by the company…

Applicant’s Screening Test Score _________ Reviewed & accepted by: _________________________________

Officer’s Name: _______________________________________