Employment Application Form

Located At:

120 West Allen Street

Rice Lake, WI 54868

Call our recruiter Brook Van Erp at:

715-736-9204

Name:*

First NameLast Name

Phone Number:*

Area CodePhone Number

E-mail Address:

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Shift Desired

1st Shift2nd Shift3rd Shift

Are there any hours you are not available blanks

Date Available to start

Date

Are you legally eligible to work in the United States?

YesNo

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

YesNo

Position applied for blanks

Were you referred by anyone, if so, who?blanks

Have you every worked for this company?

YesNo

If yes, when?

Are you at least 18 years old?

YesNo

Education

High School Name: blanks
No. Years Completed: blank
Major or Degree:   First Name
College Name:   First Name
No. Years Completed:   First Name
Major or Degree:   First Name
Other Names and Location of School:   First Name
No. Years Completed:   First Name
Major or degree:   First Name

Previous Employment

Company: blanks Phone:   Area Code   Phone Number
Address:
Street Address   Address Line 2   City   State   Zip
Job Title:   Type a label   Starting Salary:  Type a label
Ending Salary:   Type a label
Responsibilities:   Type a label
From:   Type a label   To:   Type a label   Reason for Leaving:   Type a label
May we contact your previous supervisor for a reference?   Yes   No

I HEREBY CERTIFY that the answers given by me to the above questions and statements are true and correct and hereby authorize you to contact references, past or present employers, and any ohter sources of informatio which may be relevant to my apllication for employment including, but not limited to , my agreement to product verivaction of prior earning. I hereby realease them and complete. I understand that, if I am employed, false or misleading statements on the application may result in my disissal at any time during my employment, without libility to this company. If employed, I agree to abide by all of the work and safety rules of the company as set forth in the company's policy manual or communications distributed by the company to its employees. I further understand that no representative of the company has the authority to enter into any agreement for employment for any specified period of time and that thais company is not guranteeing employment for anyone. No employment contract is crated by virtue of my being hired by this company. I fully understand that if hired, I will be an employee terminable at the will of the employer.

Signature

Mastercraft Industries, Inc. is an Equal Opportunity Employer