EmailMe Form - Precision Structures, Inc.

Name:

First Last

Home Phone:

### - ### - ####

Email:

Mobile Phone:

### - ### - ####

Referral Source / How Did You Hear About Us?

Position Applied For:

Are You Legally Eligible to Apply For Employment in the US?

Type of Employment Desired:

Full Time

Part Time

Seasonal

Temporary

Date You Are Available For Work:

MM / DD / YYYY

Driver's License # If Driving Is Required As Part of the Position:

Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Answering “Yes” to the Following Question Does Not Constitute an Automatic Bar to Employment. Factors Such as Date of the Offense, Seriousness and Nature of the Violation, Rehabilitation and Position Applied For Will Be Taken Into Account. Have You Ever Plead “Guilty” or “No Contest” To, or Been Convicted of a Crime? Yes or No?

If Yes, Please Provide Date(s) and Details:

Employment History

Starting with your most recent employer, provide the following information:

Employer Name:

Phone Number of Employer:

Employment Date (Example: November 2004 to October 2019):

Physical Address of Previous Employer - Street, City and Zip:

Starting Job Title:

Final Job Title:

Supervisor's Name and Title:

May We Contact For Reference?

Yes

No

Later

What Was Your Reason For Leaving This Position?

Summarize the Type of Work You Performed and Your Job Responsibilities:

What Did You Like Most About Your Position?

What Were the Things You Liked Least About the
Position?

2nd Employer History

Fill in information, if applicable, on the job you had before your most recent employment:

Employer Name:

Phone Number of Employer:

Employment Date (Example: November 2004 to October 2019):

Physical Address of Previous Employer - Street, City and Zip:

Starting Job Title:

Final Job Title:

Summarize the Type of Work You Performed and Your Job Responsibilities:

Supervisor's Name and Title:

May We Contact For Reference?

Yes

No

Later

What Was Your Reason For Leaving This Position?

Summarize the Type of Work You Performed and Your Job Responsibilities?

What Did You Like Most About Your Position?

What Were the Things You Liked Least About the
position?

Additional Employment History

If you have any further employment history, fill it in here:

Employer Name:

Phone Number of Employer:

Employment Date (Example: November 2004 to October 2019):

Physical Address of Previous Employer - Street, City and Zip:

Starting Job Title:

Final Job Title:

Summarize the Type of Work You Performed and Your Job Responsibilities:

Supervisor's Name and Title:

May We Contact For Reference?

Yes

No

Later

What Was Your Reason For Leaving This Position?

What Did You Like Most About Your Position?

What Were the Things You Liked Least About the
position?

Skills and Qualifications:

Summarize Any Special Training, Skills, Licenses and/or Certificates That May Assist You in Performing the Position For Which You Are Applying:

Do You Have Any Computer Skills In Word Processing, Spreadsheet, Powerpoint Presentations, Email Communication, Internet Research or a Similar Computer Skill? If So, How Many Years Experience Do You Have With It?

Educational Background

Starting with your most recent school attended, provide the following information:

Name of High School:

Physical Address of High School:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Please Check Off The Following Items That You Graduated With:

Diploma

GED

Other

What Was Your GPA/Class Rank?

What Subject(s) Did You Major/Specialize In?

College or Continued Education After High School

If you have been to a college institution, trade school, vocational training service or something similar, please indicate it here.

Name of Education Institution:

Physical Address of Institution:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

What Dates Did You Begin and End Attendance (Example: September 2014 - June 2018):

Did You Graduate? If So, What Degree or Certification Did You Receive?

What Subject Did You Major in or What Skill Did You Specialize in Study?

What Was Your GPA/Grade/Rank?

Additional References

Here we would like you to list any additional references of individuals who are NOT related to you and have NOT acted as a supervisor to you in your work history before.

List Up To 3 Additional References in Each Paragraph Box:

Names And Titles (If Applicable) Of References:

How Long Have You Known Them and What Is Their Relationship To You?

Telephone Or Email Address For Them:

APPLICANT STATEMENT:

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local,state or federal law. I understand that this application remains current for 90 days. If I am hired, I understand that I am free at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration.

I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States of America and that federal immigration laws require me to complete an I-9 form in this regard.

I understand that any information provided by me this is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (1) eliminate me from further consideration for employment, or (2) may result in my immediate discharge from the employer’s service, whenever it is discovered.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Sign Your Name and Date:

Do You Give Us Permission to Release Information Concerning Yourself to Precision Structures, Inc. and Release the Reference Giver From All Liability Associated With This Information?

Yes

No