Application for Employment

To be considered for employment, please fill out our employment application. Note that the fields marked in Red are required.
You may also mail the application to PO Box 525, Swanton, OH 43558. No phone calls please.

PRE-EMPLOYMENT QUESTIONAIRE
EQUAL OPPORTUNITY EMPLOYER

Date:

Dec 04, 2008

Personal Information

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone:

Referred By:

Employment Desired

Position:

Date you can start:

Salary Desired:

Are you employed?
YES

If so may we inquire of your present employer?
YES

Ever applied at this company before?
YES

Where:

Name & Location of School	Years Attended	Graduated	Subject Studied
Grammar School:		YES
High School:		YES
College:		YES
Trade, Business or Correspondence:		YES

General
Subjects of special study, research work or special training skills:	U.S. Military or Naval Service:	YES
	Rank:

Former Employers
List last three employers starting with last one first
From:	(mm/dd/yyyy)	Name:
To:	(mm/dd/yyyy)	Address:
Salary:		Position:
Reason for leaving:
From:	(mm/dd/yyyy)	Name:
To:	(mm/dd/yyyy)	Address:
Salary:		Position:
Reason for leaving:
From:	(mm/dd/yyyy)	Name:
To:	(mm/dd/yyyy)	Address:
Salary:		Position:
Reason for leaving:

Work References
List three persons not related to you, which you have known at least one year
Name:		Business:
Address:		Years Known:
Name:		Business:
Address:		Years Known:
Name:		Business:
Address:		Years Known:

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 REFERRENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINET 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 CONTRARY TO THE AGRREMENT 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.

I agree to the statement above.