Application For Employment – Thompson's Welding

Date *

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Personal Information

Name (Last Name First) *

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Social Security No. *

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Present Address

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City

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State

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Zip

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Permanent Address

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City

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State

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Zip

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Phone Number

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Secondary Phone Number

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Referred By

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Employment Desired

Position

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Date You Can Start

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Salary Desired

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Are You Employed Now?

Yes

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Can We Contact Them?

Yes

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Are You Legally Authorized To Work In The U.S.?

Yes

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Ever Applied To This Company Before?

Yes

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Where

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When

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Education History

High School

Name Of School

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Years Attended

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Did You Graduate

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Subjects Studied

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College

Name Of School

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Years Attended

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Did You Graduate

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Subjects Studied

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Trade School

Name Of School

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Years Attended

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Did You Graduate

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Subjects Studied

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General Information

Subject Of Special Study/Research Work

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Special Training

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Special Skills

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U.S. Military or Naval Service

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Rank

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Former Employers

(LIST BELOW THE LAST FOUR EMPLOYERS, STARTING WITH THE LAST ONE FIRST)

Date Started

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Name & Address

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Salary

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Position

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Reason For Leaving

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Date Started

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Name & Address

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Salary

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Position

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Reason For Leaving

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Date Started

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Name & Address

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Salary

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Position

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Reason For Leaving

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Date Started

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Name & Address

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Salary

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Position

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Reason For Leaving

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Reference

(GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.)

Name

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Address

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Business

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Years Known

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Name

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Address

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Business

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Years Known

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Name

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Address

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Business

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Years Known

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Authorization

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”

DATE *

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SIGNATURE *

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