THE ULTIMATE ZINC PLATING COMPANY (608) 524-8241

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

    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

    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

    MILITARY SERVICE

    Branch

    From:

    To:

    Rank at Discharge

    Type of Discharge

    If other than honorable, explain

    DISCLAIMER AND SIGNATURE

    I certify that my answers are true and complete to the best of my knowledge.
    If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

    Signature

    Date