Employment Application

APPLICANT INFORMATION

First Name

Middle Initial

Last Name

Street Address

Apartment/Unit #

City

State

ZIP

Phone

Email Address

Date Available

Social Security No.

Desired Salary

Position Applied for

Are you a citizen of the United States?
YesNo

If no, are you authorized to work in the U.S.?
YesNo

Have you ever worked for this company?
YesNo

If so, when?

Have you ever been convicted of a felony?
YesNo

If yes, explain.

EDUCATION

High School

High School Address:

From:

To:

Did you graduate?
YesNo

HSEDGED

College

College Address:

From:

To:

Did you graduate?
YesNo

Other School

Other Address:

From:

To:

Did you graduate?
YesNo

REFERENCES

Please list three professional references.

Reference 1




Reference 2




Reference 3




PREVIOUS EMPLOYMENT

Company 1

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for Leaving

May we contact your previous supervisor for a reference?
YesNo

Please list reason for any gap of employment from previous employer.

Company 2

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for Leaving

May we contact your previous supervisor for a reference?
YesNo

Please list reason for any gap of employment from previous employer.

Company 3

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for Leaving

May we contact your previous supervisor for a reference?
YesNo

Please list reason for any gap of employment from previous employer.

MILITARY SERVICE

Branch

From:

To:

Rank at Discharge

Type of Discharge

If other than honorable, explain

SPECIAL SKILLS, KNOWLEDGE, TRAINING (PLEASE LIST CERTIFICATIONS, TRAINING, TOOLS THAT MAY QUALIFY YOU AS BEING ABLE TO PERFORM JOB-RELATED FUNCTIONS FOR WHICH YOU ARE APPLYING FOR, SUCH AS COMPUTER SKILLS, FORKLIFT , ETC.

From:

To:

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge and that I have not purposefully withheld any information that might adversely affect my chances of hire.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.
If I am hired, I understand that I am free to resign at any time with or without prior notice, and the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period of definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by a designated member of management.
I permit the company to examine my references, records of employment, education record, and any other information I have provided. I authorize the references that I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers and all other persons, corporations, partnerships and associations from any & all claims, demands, or liabilities arising out of or in any way related to such examination or revelation.
I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state, or federal law.
I understand that this application remains current for 90 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that the federal immigration laws require me to complete an I-9 Form in this regard.

Plateco requires pre-employment drug testing.

Signature

Date

****NOTE: Plateco operates three productions shift. Please indicate your shift preferences below:
First ShiftSecond ShiftThird Shift

How did you hear of our job openings?