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Employment


Specialty Products Company Employment Application

Name:*
Phone Number:*
-
E-mail:*
Address:*
Position Desired
Date You Can Start
Salary Desired
Are you currently employed?
Current Employer
Can we contact your current employer?

Current Employer Contact Information


Contact Name
Contact Phone Number
1/5
Education Information

High School


Name of High School
High School Location
Did you graduate High School?
High School Graduation Year

Technical School                                                                         


Name of Technical School
Technical School Location
Did you graduate Technical School
Technical School Graduation Year
Subjects studied in Technical School

College                                                                                         


Name of College
College Location
Did you graduate College
College Graduation Year
What degree did you earn?
Subjects studied in College
Additional Education
Genreal Information
2/5
Work Experience

Former Employers (List below the last 3 employers, starting with the most current)

Last Employer


Name of last employer
Address of last employer
Final salary at last employer
Date Started Last Employer
 / 
 / 
Date Left Last Employer
 / 
 / 
Reason for leaving last employer

Previous Employer                                                                      


Name of previous employer
Address of previous employer
Final salary at previous employer
Date Started Previous Employer
 / 
 / 
Date Left Previous Employer
 / 
 / 
Reason for leaving previous employer

3rd Employer                                                                                


Name of 3rd employer
Address of third employer
Final salary at 3rd employer
Date Started 3rd employer
 / 
 / 
Date Left 3rd employer
 / 
 / 
Reason for leaving 3rd employer
Education Information
3/5
Military Service/References
US Military Service Branch
Type of Discharge
Date enlisted
 / 
 / 
Date Left Service
 / 
 / 

Reference 1                                                                                 

Reference 1 Name
Reference 1 Address
Reference 1 Phone Number
-
Business Reference 1
Years Known Reference 1

Reference 2                                                                                   

Reference 2 Name
Reference 2 Address
Reference 2 Phone Number
-
Business Reference 2
Years Known Reference 2

Reference 3                                                                                    

Reference 3 Name
Reference 3 Address
Reference 3 Phone Number
-
Business Reference 3
Years Known Reference 3
Work Experience
4/5
Resume - Submit Application

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File types allowed: jpg, jpeg, png, gif, doc, docx, xls, xlsx

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Authorization

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application for be grounds for dismissal.

I authorize an investigation of all statements contained herein and the references and employers 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 the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into agreement for employment for any period of specified time, to to make any agreement contrary to the forgoing, unless it is in writing and signed by the authorized company representative.

This waiver does not permit the release of disability related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and any other relevant federal and state laws.

I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will obtain a separate written authorization from me to consent to these reports.I also understand that a poor credit history or conviction will not automatically result in disqualification from employment.”

In compliance with federal law, all persons hired will be required to verify identify and eligibility to work in the United States and to complete the required employment eligibility verification document upon hire.


By submitting this application I agree to the above.


Military Service/References
5/5

 

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