Apply for a job in our shop PRE-EMPLOYMENT QUESTIONAIRE – AN EQUAL OPPORTUNITY EMPLOYER Please enable JavaScript in your browser to complete this form.PERSONAL INFORMATIONToday's Date Name *FirstMiddleLastPresent Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePermanent AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Are you prevented from lawfully becoming employed in this country because of visa or immigration status? *YesNoAre you 18 years of age or older? *YesNoEMPLOYMENT DESIREDPosition SoughtFabricatorMetal FinisherMaintenanceOtherDate you can startEver applied here before?YesNoEDUCATIONGRAMMAR SCHOOL NAME & TOWNNUMBER OF YEARS ATTENDEDDID YOU GRADUATE?YesNoSUBJECTS STUDIEDHIGH SCHOOL NAME & TOWNNUMBER OF YEARS ATTENDEDDID YOU GRADUATE?YesNoSUBJECTS STUDIEDCOLLEGE NAME & TOWNNUMBER OF YEARS ATTENDEDDID YOU GRADUATE?YesNoSUBJECTS STUDIEDTRADE SCHOOL NAME & TOWNNOTE: This form has been revised to comply with the provisions of the Americans with Disabilities Act and the final regulations and interpretive guidance promulgated by the EEOC on July 26, 1991. NUMBER OF YEARS ATTENDEDDID YOU GRADUATE?YesNoSUBJECTS STUDIEDSUBJECT(S) OF SPECIAL STUDYSPECIAL SKILLS OR TRAININGACTIVITIES (CIVIC, ATHLETIC, ETC.)(EXCLUDE ORGANIZATIONS, THE NAME OF WHICH INDICATES THE RACE, CREED, SEX, MARITAL STATUS, COLOR OR NATION OF ORIGIN OF ITS MEMBERS.)VALID PA DRIVER'S LICENSE *YesNoSERVED IN U.S. ARMED FORCESYesNoHIGHEST PAY GRADE ATTAINEDPRESENT MEMBER IN NATIONAL GUARD OR RESERVES?YesNoFORMER EMPLOYERSLIST LAST FOUR EMPLOYERS STARTING WITH MOST RECENT FIRST1. EMPLOYER NAME & ADDRESSANNUAL SALARYJOB TITLEEND DATESTART DATEREASON FOR LEAVINGCONTACT NAME & PHONE2. EMPLOYER NAME & ADDRESSANNUAL SALARYJOB TITLEEND DATESTART DATEREASON FOR LEAVINGCONTACT NAME & PHONE3. EMPLOYER NAME & ADDRESSANNUAL SALARYJOB TITLEEND DATESTART DATEREASON FOR LEAVINGCONTACT NAME & PHONE4. EMPLOYER NAME & ADDRESSANNUAL SALARY JOB TITLEEND DATESTART DATEREASON FOR LEAVINGCONTACT NAME & PHONEWHICH OF THESE JOBS DID YOU LIKE BEST?WHAT DID YOU LIKE MOST ABOUT THIS JOB?REFERENCESLIST THE NAMES OF THREE PERSONS NOT RELATED TO YOU THAT YOU HAVE KNOWN AT LEAST ONE YEAR1. NAMEADDRESSPHONE NUMBERYEARS KNOWN2. NAMEADDRESSPHONE NUMBERYEARS KNOWN3. NAMEADDRESSPHONE NUMBERYEARS KNOWNAre you legally permitted to work in the United States?YesNoAre you more than 18 years of age?YesNoHave you ever been convicted of a crime other than misdemeanor?YesNoIf yes, explain below.ExplanationMay we contact your present employer for references?YesNoMay we contact your previous employers for references?YesNoIS THERE ANYTHING ELSE YOU WOULD LIKE TO TELL US ABOUT YOURSELF?(OPTIONAL) If you have a resume you may upload it here Click or drag a file to this area to upload. (OPTIONAL) If you have a cover letter, you may upload it here Click or drag a file to this area to upload. (OPTIONAL) Any additional Information may be entered hereSubmit50331
