Employment – Wire Products Inc.

Page 1

Wire Products Inc. is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

This form is divided into multiple pages for ease of use. Please fill out all of the sections on the following pages.

Click the Next button to begin your application.

Page 2

APPLICANT INFORMATION

Applicant Name *

Applicant Address *

Country

City

State

Zip code

Phone *

Email *

Date of Application *

Page 3

EMPLOYMENT POSITION

Position(s) applying for:

How did you hear about this position? *

What days are you available to work? *

What hours or shift are you available for work? *

If needed, are you available to work overtime? *

Yes

No

On what date can you start working if you are hired? *

Salary Desired (specify hourly, weekly, etc.) *

Page 4

PERSONAL INFORMATION

Have you ever applied to or worked for Wire Products Inc. before? *

Yes

No

If yes, when?

Do you have any friends, relatives, or acquaintances working for Wire Products Inc.? *

Yes

No

If yes, state name and relationship:

Are you 18 years of age? *

Yes

No

Are you a U.S. citizen or approved to work in the United States? *

Yes

No

What document can you provide as proof of citizenship or legal status? *

Have you ever been convicted of a criminal offense (felony or misdemeanor)? *

Yes

No

If yes, please state the nature of the crime(s), when and where convicted and disposition of the case:

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Page 5

JOB SKILLS / QUALIFICATIONS

Please list below the skills and qualifications you possess for the position for which you are applying: *

(Note: Wire Products inc. complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. )

Page 6

EDUCATION AND TRAINING

High School Attended *

High School Location *

Year Graduated *

Diploma Earned? *

Yes

No

College Attended *

College Location

Year Graduated

Degree Earned

Vocational School / Specialized Training Attended *

Location

Year Graduated

Degree / Certificate Earned

Page 7

MILITARY

Are you a member of the Armed Services? *

Yes

No

In what branch of the military did you enlist?

What was your military rank when discharged?

How many years did you serve in the military?

What military skills do you possess that would be an asset for this position?

Page 8

PREVIOUS EMPLOYMENT

Employer Name *

Your Job Title *

Supervisor Name *

Employer Address *

Country

City

State

Zip code

Employer Phone *

Dates Employed (Start and End) *

Reason For Leaving *

Employer Name *

Your Job Title *

Supervisor Name *

Employer Address *

Country

City

State

Zip code

Employer Phone *

Dates Employed (Start and End) *

Reason For Leaving *

Employer Name *

Your Job Title *

Supervisor Name *

Employer Address *

Country

City

State

Zip code

Employer Phone *

Dates Employed (Start and End) *

Reason For Leaving *

Page 9

REFERENCES

Please provide three (3) personal and/or professional references below:

Reference 1 *

Address *

Country

City

State

Zip code

Phone *

Email *

Reference 2 *

Address *

Country

City

State

Zip code

Phone *

Email *

Reference 3 *

Address *

Country

City

State

Zip code

Phone *

Email *

The relationship between you and the Wire Products Inc. is referred to as “employment at will.” This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Wire Products Inc. No representative of Wire Products Inc. has authority to enter into any agreement contrary to the foregoing “employment at will” relationship. You understand that your employment is “at will,” and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company’s President.

By signing below, I certify all information is true and correct to the best of my knowledge.

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