First Name (required)
Last Name (required)
Street Address (required)
City (required)
State (required)
ZIP (required)
Birthdate DD/MM (required)
Phone (required)
Your Email
If you are under 18 (and it is required), could you get a Work Permit? Yes No I'm 18 or older
Have you submitted an application here before? Yes No
Have you ever been employed with Powder Cote II, Inc.? Yes No
Are you legally eligible for employment in this country? Yes No
When are you available to start? (DD/MM)
What shift/days are you available to work? Days Afternoons Either Shift
Have you been convicted of a crime in the last 7 years? (A conviction will not necessarily be a bar to employment.) Yes No
If you answered Yes to the previous question, please explain: (Each instance and explanation will be considered in relation to the position for which you are applying.)
Do you have reliable transportation? Yes No
Position Applying For:
Referred By: Current/Past EmployeeAdvertisementWalk-InNone
Referrer Name
If you do not have an employment history, please list personal references.
Employer
Phone Number
Street Address
City
State
ZIP
Date Employment Began
Date Employment Ended
Reason Employment Ended: (leave blank if you are still employed by this employer)
Hourly Wage
Supervisor Name
Job Description
May we contact this employer for a reference? Yes No
Please refer to your highest level of education.
School Name & Location
Years Attended
Degree Earned GEDHigh School DiplomaAssociates DegreeBachelors DegreeMasters DegreeDoctoral DegreeHave not graduated / currently attendingDid not graduate
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