Employment Application

We are an equal opportunity Employer

Part-Time or Full-Time Desired	Salary Preference	Shift Preference
Application Information
First Name	Middle Name	Last Name

Address
Address continued (Apartment number, etc)
City
State
Zip Code
Day Telephone
Evening Telephone
Social Security Number
If you have any other names under which you have worked or attended school please provide a list for checking purposes.
Are you legally authorized to work in the U.S.? (if hired, you will be required to provide proof of work authorization.)	Yes No
Are you at least 18 years old?	Yes No
if not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and have obtained a vlid work permit.
Have you ever been convicted of a crime or pleaded no contest for any offense or violation other than minor traffic violations?		Yes No
If yes, explain: 1) nature of crime, 2) date of conviction, and 3) state in which convicted. (Convictions are not an automatic bar to employment.)
Do you have any pending charges against you?		Yes No
If yes, describe the 1) nature of charges, 2) date issued, and 3) county and state in which convicted.
Have you ever applied at this company before? Yes No If yes, when:	Have you ever worked at this company before? Yes No If yes, when:
Position Applying For
Part-Time Full-Time Either
Location
Date you can start
How were you referred to the company?	Agency Walk-in Friend/Relative Newspaper School Other
Special Skills
1. If relevant, please describe work processing speed, software knowledge, and office equipment experience.
2. If relevant, please describe experience usig manufacturing machines and equipment.