Employment Application

Applicant Full Name
Address

Home Address

Street Address Line 2

City/State/ZIPState / Province

Postal / Zip Code
Mobile phone
Date of Birth
Driver's License (State/Number)
Address

Address

Street Address Line 2

City/State/ZIPState / Province

Postal / Zip Code
Daytime phone
Evening phone
Job Position Applied For:
Who referred you to our company?
Do you have any friends or relatives who work here? If yes, please list here
Are you at least 18 years old?

YESNO
How will you get to work?
Are you willing to work any shift, including nights and weekends? If no, please state any limitations:

YESNO
If no, please state any limitations:
If applicable, are you available to work overtime?

YESNO
If you are offered employment, when would you be available to begin work?
If hired, are you able to submit proof that you are legally eligible for employment in the United States?

YESNO
Are you able to perform the essential functions of the job position you seek withor without reasonable accommodation?

YESNO
What reasonable accommodation if any, would you request?
Years of Experience
Welding
Fabrication
Electrical
Mechanical
Problem Solving
Heavy Equipment
Other
Employment History
Employer Name
Supervisor Name
Address

Address

Street Address Line 2

City/State/ZIPState / Province

Postal / Zip Code
Job Duties
Reason for Leaving
Dates of Employment (Month/Year)

MonthDayYear
Date
Employer Name
Supervisor Name
Address

Address

Street Address Line 2

City/State/ZIPState / Province

Postal / Zip Code
Job Duties
Reason for Leaving
Dates of Employment (Month/Year)

MonthDayYear
Date
Applicant's Education and Training
College/University Name and Address
Did you receive a degree?

YESNO
If yes, degree(s) received
High School/GED Name and Address
Did you receive a degree?

YESNO
Other Training (graduate, technical, vocational)
Please indicate any current professional licenses or certifications that you hold
Awards, Honors, Special Achievements
Military Service

YESNO
Branch
Specialized Training
References
Name
Address

Address

Street Address Line 2

City/State/ZIPState / Province

Postal / Zip Code
Telephone
Relationship
Name
Address

Address

Street Address Line 2

City/State/ZIPState / Province

Postal / Zip Code
Telephone
Relationship
Please provide any other information that you believe should be considered, including whether you are bound by any agreement with any current employer:
I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application. or if employment commences. immediate termination.

I authorize Precision Maintenance Solutions Inc to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.
APPLICANT SIGNATURE

Clear
DATE

MonthDayYear
Date
Should be Empty:

Years of Experience

Employment History

References