EmailMe Form - WWCPI Job Application

Job Application - Equal Opportunity Employer

Complete the entire form. Incomplete applications will not be considered as legitimate employment inquires.

All job applicants are subject to testing for the presence of illegal drugs as a condition of employment. Any applicant with a confirmed positive test result or a diluted or altered specimen will be denied employment.

Tobacco users are excluded from employment consideration. All job applicants are subject to testing for nicotine.

Instructions: Please enter your information. Answer all questions

Position applying for: *

Only available open positions will be listed

Name *

First Last

Address *

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

PERSONAL INFORMATION

Phone Number *

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

Drivers license number *

Drivers license state *

Email

Are you 18 or older? *

Yes

No

I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States. *

Yes

No

Have you ever applied at this corporation or any of its afflicated companies? *

Yes

No

Have you ever been employed by this corporation or any of its afflicated companies? *

Yes

No

If yes, indicate where and when:

List anyone you know who is employed here:

If you do not know anyone employed here, list none in the box.

Who referred you to this corporation?

Have you ever been convicted of a felony? *

Yes

No

If yes, explain number of convictions(s), nature of offense(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Have you ever been discharged or forced to resign from any position? *

Yes

No

If yes, give details.

Military service? *

Yes

No

Special military training received:

If you do not have any, list none in the box.

Are you a licensed member of any profession or trade? *

Yes

No

Certificate number:

AVAILABILITY:

Employment desired *

Full-time

Part-time

Temporary

Can you work any shift? *

Yes

No

Choose a shift preference *

1st shift

2nd shift

3rd shift

I have no preference

Can you work weekends? *

Yes

No

Salary *

Input hourly wage, if salary list annual amount.

What date are you available to start work? *

MM / DD / YYYY

EDUCATION:

Basic education - Check highest grade completed: *

Name of last school attended: *

Did you attend a college, university or trade school? *

Yes

No

If yes, complete the following information.

Name and Address Of School - Degree/Diploma

Please list any special skills or qualifications you may have: *

If you do not have any, list none in the box.

Please list any equipment, machinary or instruments you can operate: *

If you do not have any, list none in the box.

Specialized computer skills: (Check all that apply) *

List any honors and activities (leadership roles, organizations and awards.) Please omit any organizations or activities that would divulge race, age, ethnic group or religious persuasion. *

If you do not have any, list none in the box.

Other information:

You may use this space to list any other information necessary to answer fully any of the previous questions, or to add additional information about yourself that you wish to be considered.

Upload your resume (optional)

Upload a cover letter (optional)

EMPLOYMENT HISTORY:

Start with your Present or Last Position:

May we contact your present employer? *

Yes

No

Employer: *

Address: *

Supervisor: *

Phone Number *

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

Email

Position Title: *

Start Date *

MM / DD / YYYY

End Date *

MM / DD / YYYY

Responsibilities: *

Salary *

Input hourly wage, if salary put in a annual amount.

Reason for Leaving: *

Previous Position

Employer:

Address:

Supervisor:

Phone Number

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

Email

Position Title:

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

Responsibilities:

Salary

Input hourly wage, if salary list annual amount.

Reason for Leaving:

Business References (No Relatives):
Name/Title Address Phone *

EMPLOYMENT AUTHORIZATION

I understand that this application and any attachments are property of Wayne Wire Cloth Products, Inc. (WWCPI).

I certify that the statements made by me in this application may cause rejection of the Application of dismissal if such false statements are discovered subsequent to my employment.

Any offer of employment is dependent upon my satisfactorily passing a test for drug usage. Any offer of employment tendered to me is based upon my agreement to abide by the rules and regulations of this Corporation and its affiliated companies.

If I am selected for hire I will be offered employment provided I verify that I am authorized to work as required by the Immigration Reform and Control act of 1986.

I understand that the Corporation may make an inquiry concerning my character, reputation, personal characteristics and mode of living, as well as my past employment. I hereby release the Corporation and my current and previous employers, as well as their respective agents and employees, from any and all claims arise in any way from this participation in such as inquiry or investigation and I waive any right to receive any notice concerning disclosures made as a part of such inquiry or investigation. I also release the Corporation and the medical/technical testing agencies, as well as their perspective agents and employees from any and all claims arising in any way from their administration or use of results from physical examination of me, including any laboratory tests, and I authorize the medical/testing agencies conducting the examination and/or test to report the results thereof to the Corporation, its agents and employees.

I authorize the references listed in this application for Employment and any prior employer, educational institution, or any other persons or organizations to give this Company any and all information concerning my previous employment/that such information may contain my social security number. I release all parties from liability for any damage that may result from furnishing that information to this company. In addition, I hereby waive written notice that employment information is being provided by any person or organization.

I further understand that this application will remain active for a period on thirty (30) days form the date of completion and that I must notify the Corporation in writing at the end of such thirty day period if I wish to re-activate or amend this application.

I understand and agree that any employment obtained with the Corporation shall be at such wages, benefits, hours, and conditions as the Corporation may determine and change from time to time such employment shall be for no definite term and can be terminated by the Corporation at any time, with or without cause, and with or without notice, regardless of the date or period of payment of wages or salary, and regardless of any contrary provisions in any other forms, manuals, handbooks, etc. I understand that no one other than the President of the Corporation has any authority to enter into any agreement for employment for a specified period of time or to make any agreement which contrary in any way to the foregoing and that such agreement must be in writing and personally signed by me and the President or it shall not be binding.

I agree that any action or suit against the company arising out of my employment or termination of employment, including but not limited to claims arising under State and Federal civil rights statutes, must be brought within 180 days of the event giving rise to the claim or be forever barred.

If is the policy of this Company to ensure equal opportunity all qualified employees and applications for employment without regard to race, color, religion, sex, age, national origin, handicap, or other protected characteristics and positive action shall be taken to insure the fulfillment of this policy.

Do you agree with the terms and conditions listed above? *

Yes, I agree.

Initial *