EmailMe Form - On-Site Employee Application

How the Process Works:

• Must be completed by the applicant.
• Fill out this form from top to bottom, fields may change based on answers
• You'll receive a copy of your form submission to keep on file.
• Follow up in 1-2 weeks to check the status of your application.

IMPORTANT - You can save this form to return later, but you MUST save the web link given on the web page after saving. It will not be emailed to you. We do not have access to your temporary data or link saved prior to you completing the application. Copy and paste it for later. Applications can be saved up to 30 days. Data will be lost after 30 days.

We'll Review Your Application as Soon as Possible.

• Our team will email and/or call you.
• We'll schedule an interview with you if you're a good fit.
• We'll finalize all paperwork.
• Your position will begin on the agreed upon start date.

Applicant Info

Name *

First MI Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

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

Email *

Make sure this email is correct so we can contact you. A copy of this application will also be sent to this email address.

Confirm Email

Permission to Contact *

I give 5 Star Industrial Coatings permission to send me emails.

Position Applying for *

Desired Salary *

$ Dollars

When can you start? *

MM / DD / YYYY

Are you a citizen of the United States? *

Yes

No

Are you authorized to work in the United States? *

Yes

No

Have you ever worked for this company? *

Yes

No

When did you work for this company? *

Have you ever been convicted of a felony? *

Yes

No

Please explain: *

Education

High School Name *

High School Address *

Years Attended High School *

(i.e. xxxx - xxxx)

Did you graduate high school? *

Yes

No

High School Diploma *

Did you attend college? *

Yes

No

College Name *

College Address *

Years Attended College *

(i.e. xxxx - xxxx)

Did you graduate college? *

Yes

No

College Diploma *

Previous Employment

Do you have any previous work experience? *

Yes

No, this would be my first job.

Company #1 Name *

Company #1 Address *

Company #1 Phone *

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

Supervisor Name *

First MI Last

Starting Salary *

$ Dollars

When did you work for this company? *

(Date range i.e. month/yr - month/yr)

Describe your job responsibilities... *

Reason for Leaving *

(Date range i.e. month/yr - month/yr)

May we contact your previous supervisor for a reference? *

Yes

No

Do you have another previous job you can list? *

Yes

No

Company #2 Name *

Company #2 Address *

Company #2 Phone *

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

Supervisor Name *

First MI Last

Starting Salary *

$ Dollars

When did you work for this company? *

(Date range i.e. month/yr - month/yr)

Describe your job responsibilities... *

Reason for Leaving *

(Date range i.e. month/yr - month/yr)

May we contact your previous supervisor for a reference? *

Yes

No

Military Service

Did you serve in the military? *

Yes

No

Branch *

Thank you for your service.

Rank at Discharge *

Date range i.e. month/yr - month/yr)

When did you work for the military? *

What type of discharge? *

Honorable

Another kind (please explain)

Please explain: *

Upload any other document you'd like to include:
(i.e. references, cover letter)

Word or PDF Documents Only

DISCLAIMER & SIGNATURE

I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired.

At the time of application, I attest that I have the legal right to reside and work in this country (proof required upon employment). I understand I must provide a current Driver Motor Vehicle report with this application. I authorize any person, organization, or company listed on this application to furnish you any and all information concerning my previous employment, education, and qualifications for employment. I also authorize you to request and receive such information including, but not limited to, any criminal conviction on my record.

In consideration for my employment, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added, or interpreted at any time, without prior notice to me.

I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, by either myself or 5 Star Industrial Coatings, LLC, for any reason not expressly prohibited by law.

Nothing on this application is intended to create or imply a contractual relationship, if hired the employee understands that employment is at will, that it is not for any specific time period or duration, and can be terminated with or without reason at any
time.

Signature *

Clear

Date Signed *

MM / DD / YYYY