Position Applied For*:
Date*:
NOTE TO APPLICANT: This application is used to evaluate your qualifications for employment. Please answer all of the questions on your application accurately. If you fail to do so, you may lose employment opportunities or delay consideration of your employment at Mid States Rebar and Supply. This application is not an employment contract. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, disability, age, sex, or any other classification protected by federal, state, or local laws. Additional testing of job-related skills, as well as post-offer pre-employment physical (which will include a drug test) may be required.
Name*:
Address:
City:
State:
Zip Code:
Telephone Number*:
Cell/Alternate:
Are you at least 18 years of age:
YesNo
Email*:
(Child Labor laws prohibit employment of individuals under the age of 18 in certain occupations considered to be hazardous)
Are you eligible for employment in the United States?
Do you speak, read, or write fluently a language other than English?
If YES, please describe ability and list of language(s):
Who referred you?
On what date would you be available for work?
Are you available to work:
Full-timePart-timeShiftTemporary
Are you on layoff and subject to recall?
Do you have valid drivers license?
If YES, please specify the type(s) of licenses(s):
OperatorsCDLOther
Other, please specify:
License Number:
Expiration Date:
What types and makes/models of equipment can you operate and/or repair?
List any craft training programs in which you have participated:
Summarize special skills and qualifications acquired from employment or other experiences:
What is your highest level of education completed?
Applicant's Initials*:
Your training and employment experience will be used to determine whether you meet the entrance requirements for this position here at Mid States Rebar and Supply and to measure your knowledge, skills and abilities in competing for this position. Therefore, please provide a full and accurate description of the responsibilities and achievements in your jobs and other pertinent life experiences. Include self-employment, volunteer experience, and any non-employment periods.
Start Date:
End Date:
Employer:
Phone Number:
Position Held/Duties:
Supervisor:
May we contact?
Starting Pay:
Ending Pay:
Reason for leaving:
If you have a resume please email it to anne@midstatesrebarsupply.com.
"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, and I agree to hold my employer harmless in the event of my dismissal based thereon.
I authorize investigation of all statements contained herein this application and on my resume submitted and to background checks to give you all information concerning my previous employment and any pertinent information they may have, confidential or otherwise, and release all parties from liability for any damage that may result from furnishing same to you.
I understand and agree that if hired, my employment is for no definite period and may, regardless of the method of payment of my wages and salary, be terminated at any time without prior notice or reason. If employment is obtained under this application, I will comply with all the rules and policies of my employer."
Signature of APPLICANT?
Yes
Send
