Employee Application - Precision Press Inc.

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Employment Application

AN EQUAL OPPORTUNITY EMPLOYER

To Applicant: Read the introduction carefully before answering any questions. Various federal and state laws, as well as regulations for federal government contractors, prohibit discrimination because of race, color, religion, sex, national origin, age, handicap and/or military service during the Vietnam era. None of the questions contained herein are intended to elicit information in violation of these laws or to be used in a discriminating manner. All applicants will be requested to submit to a test for intoxicants prior to employment. Failure to submit to a test will result in withdrawal of a conditional offer of employment. No applicant will be asked to take a test unless an offer of employment has been made. All offers of employment are conditional upon a negative test result. Copies of the company's Drug and Alcohol Policy are available upon request.

Items denoted with an * are required.

Personal Information
First Name *
Middle Name
Last Name *
Social Security Number			ex. 123-45-6789
Date of Application
Address *
City *
State *
Zip Code *
Phone Number			ex. 507-456-7890
Best Time to Call
E-mail Address
Applying For? *		Full-Time Part-Time
		Mornings Afternoons Evenings Nights
Do You Desire Employment For?*		Less Than One Year Two or More Years One to Two Years
If currently a student when will you graduate?		Month	Year
How many hours per week can you work?*
Are you 18 years of age or older?* Yes No
Are you presently employed?* Yes No
If you are employed, what is your present status?		Active Layoff Strike If Other, Explain
Are you legally permitted to work in the U.S.?* Yes No
Proof of Citizenship or Immigration Status and authority to work in the U.S.will be required upon employment.
How were you referred?
		If Other, Explain
Have you ever been convicted of a felony?* Yes No
Previous conviction will not automatically result in disqualification for employment.
If Yes, Explain
Type of Position Desired
Salary Expected
Date Available
Have you previously been employed by this company?* Yes No
If Yes,	Where?
	When?
Are you willing to relocate if the opportunity arises? Yes No
Do any of your friends or relatives other than your spouse work here? * Yes No
If Yes,	Name
	Relationship
	Location

Education and Skills
High School Name*
City and State Where Located
Course of Study
Highest Grade		Grade Avg	ex. 1.23 or B
Graduate / Degree	Yes No
College Name
City and State Where Located
Course of Study
Highest Grade		Grade Avg	ex. 1.23 or B
Graduate / Degree
Graduate / Technical School Name
City and State Where Located
Course of Study
Highest Grade		Grade Avg	ex. 1.23 or B
Graduate / Degree
Business / Other School Name
City and State Where Located
Course of Study
Highest Grade		Grade Avg	ex. 1.23 or B
Graduate / Degree
Summarize Special Skills And Qualifications Acquired From Employment or Other Experience

Military Service
Branch of Military
Enlisted	From:	To:	ex. 09/15/2000
Rank At Separation or Discharge
Principal Military Duties
Special Training Received

Employment History
Employer #1
Address
Phone Number	ex. 507-456-7890
Dates of Service	From:	To:	ex. 09/15/2000
Salary or Hourly Rate	Starting: Ending:
Supervisor's Name
Supervisor's Title
Your position
Major duties
Number of people you supervised
Reason for Leaving
Employer #2
Address
Phone Number	ex. 507-456-7890
Dates of Service	From:	To:	ex. 09/15/2000
Salary or Hourly Rate	Starting: Ending:
Supervisor's Name
Supervisor's Title
Your position
Major duties
Number of people you supervised
Reason for Leaving
Employer #3
Address
Phone Number	ex. 507-456-7890
Dates of Service	From:	To:	ex. 09/15/2000
Salary or Hourly Rate	Starting: Ending:
Supervisor's Name
Supervisor's Title
Your position
Major duties
Number of people you supervised
Reason for Leaving
Employer #4
Address
Phone Number	ex. 507-456-7890
Dates of Service	From:	To:	ex. 09/15/2000
Salary or Hourly Rate	Starting: Ending:
Supervisor's Name
Supervisor's Title
Your position
Major duties
Number of people you supervised
Reason for Leaving

Personal References (Do not list names of relatives or former employers)
Reference #1 *
Address
Phone Number		ex. 507-456-7890
Occupation
Years Known
Reference #2
Address
Phone Number		ex. 507-456-7890
Occupation
Years Known
Reference #3
Address
Phone Number		ex. 507-456-7890
Occupation
Years Known

Applicant Equal Opportunity Survey
Precision Press is an Equal Opportunity Employer and is subject to the Federal Government's rules and regulations requiring the Company to assure and promote equal opportunity for all persons without regard to race, color, religion, sex, age or national origin, as well as, requiring the Company to take affirmative action to employ and advance in employment qualified disabled veterans, veterans of the Vietnam Era and handicapped individuals. The United States government requires the Company to collect data on race, sex, ethnic classifications, handicapped, veterans and Vietnam Era veterans for the purposes of determining the impact of our employment procedures. Solely to help us comply with government record keeping, please complete the Equal Opportunity survey. Your response is voluntary and your cooperation will be appreciated. This data is for periodic government reporting and will be kept in a CONFIDENTIAL FILE separate from the Employment Application.
First Name:
Middle Name:
Last Name:
Date:
Position Applied For:
Referral Source:	If Other, Explain
Sex:	Male Female
Race/Ethnic Group:
Check if Applicable:	Vietnam Veteran Disabled Veteran
	Handicapped Individual
If handicapped or disabled, please indicate any special accommodations required to enable you to perform the job properly and safely.


Please Read Carefully - Applicant's Certification and Agreement
The facts set forth in my application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application shall be sufficient cause for dismissal. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all claims and liabilities of any nature arising from such investigations or supplying of information for such investigations. I understand that my present employer will not be contacted before I accept employment, without my specific approval. I agree to conform to the rules and regulations of the company, and understand that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the company or myself. I further understand that no representative of the company has the authority to enter into any agreement for employment for any specified period of time. I understand that an offer for employment will be contingent on my ability to prove that I am authorized to work in the United States, as required by the Immigration Reform and Control Act of 1986. I authorize release of copies of this application to other companies which are affiliated with the company to which this application was submitted.

By submitting this application and Equal Opportunity Survey on-line, you agree to the conditions stated within. Precision Press facilities are tobacco-free. Tobacco use is not allowed anywhere within Precision Press facilities. Maintaining a tobacco-free environment is a condition of employment for anyone working here.