Job Application: Production Line Lead


Programs, services and employment are equally available to everyone. Please inform the Human Resources Department if you require reasonable accommodation for the application or interview.

Title: Production Line Lead

Fields marked with an asterisk (*) must be filled out before submitting.

Applicant Data

Last Name *
First Name *
Middle Name
Address *
City *
State *
ZIP *
Phone *
Cell/Other Phone
E-mail *
Date Available To Start *
Social Security No. *
Salary Requirement *
If you are under 18 and we require a work permit, can you furnish one? Yes
No
If no, please explain
Have you worked for this company? * Yes
No
If yes, when?
Are you a citizen of the United States? * Yes
No
If not, are you legally allowed to work in the United States? Yes
No
Type of employment desired * Full-time
Part Time
Temporary
Seasonal
Have you ever pled guilty, no contest or been convicted of a crime? * Yes
No
If yes, give dates and details
Drivers license number if applicable to position
State
Who referred you to us?

Education

High School *
Address *
Number of Years Completed *
GPA *
Did you graduate? * Yes
No
College/University
Address
Number of Years Completed
GPA
Did you graduate? Yes
No
Other
Address
Number of Years Completed
GPA
Did you graduate? Yes
No

References

Name *
Phone *
Address *
City *
State *
ZIP *
Name *
Phone *
Address *
City *
State *
ZIP *

Summarize Your Special Skills or Qualifications

Summary

Previous Employment (begin with most recent position)

Employment Start Date
Employment End Date
Position(s) Held
Firm
Address
Phone
Supervisor
Title
Responsibilities
Starting Salary and Title
Ending Salary and Title
Reason for Leaving
May we contact this employer for a reference? Yes
No
 
* I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial, or medical history and other related matters as may be necessary for an employment decision. I hereby release employers, schools or persons from all liability when responding to inquiries in connection with my application.
* In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.