Job Application - Mechanical Concepts

Name

First

Middle

Last

Position Applying For:

How did you hear about us?

Email

Address

Physical address in which you reside

City

State

Zip Code

Phone

Are you legally authorized to work in the United States?

Yes
No

Have you ever been convicted of, pleaded guilty to, or received Adjudication of a crime (other than a minor traffic violation)?

Yes (If yes, please explain including dates)
No

If yes, please explain including dates.

Date Available for Work:

Salary Desired:

Are you seeking employment:

Full Time
Part Time
Temporary

Would you be available to work some overtime?

Yes
No

Would you be available to be on call some nights and weekends?

Yes
No

Education

High School Name

Location

Dates Attended

Course or Major

GED School Name

Location

Dates Attended

Course or Major

College Name

Location

Dates Attended

Course or Major

Vocational/Trade

Location

Dates Attended

Course or Major

Military/Other

Location

Dates Attended

Course or Major

Please list any information you think would be helpful in considering you for employment (i.e., scholastic honors, Articles/books published, patents, activities, accomplishments, current courses, etc.)

Please list any hobbies or recreation that you (and/or) your family enjoy:

We are an equal-opportunity employer. If you have special needs please state those below in order for us to accommodate those needs.

If applying for a job involving the use of a company vehicle, or use of a personal vehicle on company time, complete the following:

Type of driver’s license currently held

Issuing state

DL number

Number of traffic violations in the last four years

If you have an EPA card, upload it here

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Employment History

1. Employer Name

Employer 1

Title or Position

Employer 1

Address

Employer 1

Phone

Employer 1

Employment Dates (MM/YY-MM/YY)

Employer 1

May we contact this employer?

Yes
No

Employer 1

Job Duties

Employer 1

Reason for Leaving

Employer 1

2. Employer Name

Employer 2

Title or Position

Employer 2

Address

Employer 2

Phone

Employer 2

Employment Dates (MM/YY-MM/YY)

Employer 2

May we contact this employer?

Yes
No

Employer 2

Job Duties

Employer 2

Reason for Leaving

Employer 2

3. Employer Name

Employer 3

Title or Position

Employer 3

Address

Employer 3

Phone

Employer 3

Employment Dates (MM/YY-MM/YY)

Employer 3

May we contact this employer?

Yes
No

Employer 3

Job Duties

Employer 3

Reason for Leaving

Employer 3

If employers listed represents less than the last 10 years, please add below

List any job-related machines and/or equipment you are qualified to operate and any other job-related skills you possess

Business References

No personal references, please

Reference 1 Name

Reference 1

Company

Reference 1

Phone

Reference 1

Reference 2 Name

Reference 2

Company

Reference 2

Phone

Reference 2

would Adjudication Vocational/Trade

Reference 3 Name

Reference 3

Company

Reference 3

Phone

Reference 3

Upload your resume

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(Files accepted: Word Doc or PDF. File size must be below 5 MB.)

I certify that all information submitted — including any attached resume — is true and accurate. Misrepresentation may result in disqualification or termination. A drug test and background check will be required upon receiving a conditional offer of employment.

Agree