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    APPLICATION FOR EMPLOYMENT

    We consider applicants for all positions without regard to race, religion, creed, color, gender, national origin, citizenship status, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.

    APPLICANT DATA:

    HOW DID YOU HEAR ABOUT US? :

    Walk-in Advertisement Friend Employment Agency Relative Other
    If other, please specify:
    Are you under 18 years of age? Yes No
    Have you ever filled an application with us before? Yes No
    If yes, please indicate date:
    Are you currently employed? Yes No
    May we contact your present employer? Yes No

    Are you prevented from lawfully becoming employed in this Country because of Visa of Immmigration Status?

    Proof of citizenship or immigration status will be required upon employment Yes No
    On what date would you be able to start work?

    Your work availability:

    Full Time Part Time Shift Work Temporary Days Evenings Nights Weekends
    Are you currently on "lay-off" status and subject to recall? Yes No
    Can you travel if a job requires it? Yes No
    Have you been convicted of a felony in any jurisdiction? Yes No
    If yes, please explain:

    State any additional information you feel may be helpful to us in considering your application.


    Education

    Name and Address of SchoolCourse of StudyYears CompletedDiploma Degree
    High School
    Undergraduate College
    Graduate College
    Other (Specify)

    Specialized Skills & Qualifications:

    Please List current Professional Certifications, registrations, and licenses. Describe any specialized training, apprenticeships, skills, or experience.



    Former Employers

    (List below your last four employers, starting with the most recent one first.)

    Date(M/Y):Name & Address of Employer:Salary:Position:Duties:Reason for Leaving:
    From:
    To:
    From:
    To:
    From:
    To:
    From:
    To:

    References

    (Please include at least two supervisors)


    APPLICANT'S STATEMENT

    I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the release any information regarding my employment. I also authorize to check my background for any criminal record.

    This application for employment shall be considered active for a period of time not to exceed 90 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

    I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of at will employment in certain jurisdictions and that relationship may or may not be changed by any written document or by conduct unless such change is specifically acknowledge in writing by an authorized executive of this organization.

    In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate discharge from employment from our organization. I understand that I am required to abide by all rules and regulation set forth by the employer.


    Signature of Applicant:




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    Custom Fabricating & Repair
    1932 East 26th Street
    Marshfield, WI 54449

    1-800-236-8773
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