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APPLICATION FOR EMPLOYMENT AT JORDAN RIVER GALVANIZING

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Labor Positions Starting at $15/hr

Name:

Address

Email:

Phone:

Are you 18 years of age or older?

Yes

Citizenship

U.S. Citizen

Registered Alien

Military Service

How soon could you accept employment?

Have you previously applied for work at Jordan River Galvanizing?

Have you previously been employed by Jordan River Galvanizing?

Name(s) and relationship of relatives currently employed at Jordan River Galvanizing:

Name(s) of non-relatives you know employed at Jordan River Galvanizing:

Have you ever been terminated or asked to resign from prior employment?

If yes, please explain fully and indicate date, name and telephone number of person (or persons) who terminated you (or requested the resignation).

Have you ever been convicted of or pleaded no contest to a felony?

(A conviction will not automatically disqualify you form consideration) If yes, please explain fully and indicate the date of conviction

Have you ever been denied bonding, security clearance or had a professional license revoked?

If yes, please explain:

Are you willing to submit to a physical examination?

If no, please explain.

Former Employment. Please include name & address,dates employed, title/position, salary, reason for leaving, supervisor and supervisor telephone number:

High School, include highest grade completed and date graduated

College, include field of study and degree:

Other (Trades or Certifications)

Character References (Give full names and contact information of four people who have known you for at least five years)

Special skills or training related to manufacturing

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