DELUXE PLASTICS CV Job Application Form

First NameMiddle NameLast Name

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Area CodePhone Number

1st Shift (7:00am – 3:00pm)2nd Shift (3:00pm – 11:00pm)3rd Shift (11:00pm – 7:00am)Flexible

	Yes	No
I can bend my knees and pick up 20 lbs.
I can stand for 8 hours
I can walk up to 4 miles per day
I can lift 30 lbs.
I can lift 20 lbs. over my head
I can push 50 lbs.
I can pull 50 lbs.

Name of Current Employer or NONE if not Employed

Area CodePhone Number

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Area CodePhone Number

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Area CodePhone Number

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Please account for all periods of time where you were unemployed for one month or more since you left school, until the present time.

Name of High School Attended

Street Address

Street Address Line 2

CityState / Province

Name of College/University Attended

Street Address

Street Address Line 2

CityState / Province

Name of Graduate School Attended

Street Address

Street Address Line 2

CityState / Province

Name of Trade/Technical/Other School Attended

Street Address

Street Address Line 2

CityState / Province

Please list at least one previous supervisor.

Upload a File

I understand and acknowledge that my employment is at-will, which means that either I or Deluxe Plastics may terminate employment at any time and for any reason with or without notice. I also understand that no one has any authority to enter into any agreement contrary to the preceding sentence except for a written agreement signed by a member of management.

I hereby affirm that the information contained in this application (and resume, if any) is accurate and complete, and I understand that any false or misleading information or omissions will disqualify me from employment consideration or result in termination of employment, regardless of when discovered.

I hereby authorize Deluxe Plastics to (1) investigate all statements contained in this application and/or resume; (2) contact my former employers and other listed references or any other persons who can provide information relative to my employment consideration; (3) contact any persons or entities regarding my employment application; (4) and make any other inquiries that the employer deems relevant in arriving at a decision regarding my application for employment. I consent to any contacted person, including former employers, to provide information about me and I covenant not to sue any such person for information provided about me.

DELUXE PLASTICS - CLINTONVILLE EMPLOYMENT APPLICATION

APPLICANT INFORMATION

EMPLOYMENT DESIRED

EMPLOYMENT HISTORY

Current Employment:

Previous Employment:

EDUCATION HISTORY

REFERENCES

COVER LETTER & RESUME (optional)

PLEASE READ BEFORE SIGNING