Midwest Prefinishing Application

Application for Employment

Midwest Prefinishing, Inc. is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of any characteristic protected by law, including race, color, religion, age, sex, national origin, or disability.

Which position are you applying for? *

Your Contact Information

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

E-mail Address

Home Phone

Mobile Phone

Social Security Number

Are you over 18 years old?

Yes No

Do you hold a Valid Drivers License?

Yes No

Do you hold a CDL?

Yes No

If Yes,

A B

Are you eligible for employment in the United States?

Yes No

(If offered employment, you will be required to provide documentation to verify eligibility.)

During the last 10 years, have you been convicted of a crime other than a minor traffic offense?

Yes No

(A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as your age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered.)

Can you pass a drug test?

Yes No

Can you with or without reasonable accommodation perform the essential functions of this job?

Yes No

Employment

May We Contact Your Current Employer

Yes No

Employer

Address

E-mail Address

Position

Date of Employment: From

Date

Date of Employment: To

Date

Starting Salary

Ending Salary:

Supervisor

Full Time Part Time

Duties

Reason for Leaving

Employer

Address

E-mail Address

Position

Date of Employment: From

Date

Date of Employment: To

Date

Starting Salary

Ending Salary:

Supervisor

Full Time Part Time

Duties

Reason for Leaving

References

First Name

Last Name

E-mail Address

Phone

First Name

Last Name

E-mail Address

Phone

First Name

Last Name

E-mail Address

Phone

FAQ"s

Past relative jobs and machine experience ?

What are you looking for in a job-what’s important?

How can you contribute to Midwest Prefinishing?

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Midwest Prefinishing, Inc. to verify their accuracy and to obtain reference information on my work performance. I hereby release Midwest Prefinishing, Inc. from any/all liability of whatever kind and nature, which, at any time, could result from obtaining and having, an employment decision based on such information. I understand that, if I am employed by Midwest Prefinishing, Inc., falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. I authorize Midwest Prefinishing, Inc. to make a thorough investigation of all statements contained in this application about my past employment, education, and other activities. I release from liability all persons and organizations supplying such information.

E-Signature of Applicant

Date