395 Hughes Drive, Traverse City, Michigan 49696 Tel: 231-947-2120 - Fax: 231-922-0609

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231.947.2120 ph
231.922.0609 fax
800.493.2951 toll free

395 Hughes Drive
Traverse City, MI 49696

EMPLOYMENT
APPLICATION


An Equal Opportunity Employer

You will be considered for all positions without regard to race, color, religion, weight, height, sex, national origin, marital status, veteran status, the presence of a non-job-related medical condition, handicap, or any other protected status required by law.

Personal Information

Name (first, last, middle)

   

E-mail Address

Present Address

City

State

Zip

How long at this address?

Home Telephone

Social Security Number

Driver's License Number

Position you are applying for

Desired Salary

Can you travel if required?

Yes   No

Are you under 18 years of age?

Yes   No

If under 18, can you provide a work permit?

Yes   No

Applying For

Full-Time   Part-Time

  Temporary

Are you currently employed?

Yes   No

If employed, why do you wish to change?

Have you applied for employment here before?

Yes   No

Have you ever been employed by our company?

Yes   No

Do you have experience in the building materials industry?

Yes   No

On what date would you abe available to start work?

How did you learn about this company?


Advertisement
Friend
Relative
Employment Agency
Current Employee
Other

If other, please explain

May we contact your present and previous employers?

Yes   No

Have you been convicted of a felony in the last 7 years?

Yes   No

To comply with laws concerning the employment of illegal aliens,
can you provide proof of employability?

Yes   No
Proof of citizenship or immigration status will be required upon employment.
Education

Type of School

Name & Location

Major Field
of Study

Did you
Graduate?

Letter Grade
or GPA

High School
Last Attended













College









Other









List professional, trade, business, or civic activities and offices held. You may exclude membership which would reveal sex, race, religion, national origin, age, ancestry, or handicap or any other protected status.




Military Status

Branch of Service


Rank Held


Entry:


Release:


Nature of Duties


What specialized training did you receive?


Do you have a reserve or National Guard obligation?

Yes   No

If you have reserve or National Guard obligation, please describe.


Employment History
If records are under a different name, please provide name for reference purposes, starting with present or last employer. List all employment, including part-time or temporary positions.

Employer 1


Phone


Dates Employed


From: To:

Address

City

State

Zip

Salary


Beginning:


Ending:


Name of Supervisor


Reason for leaving


Title & duties at beginning of employment


Title & duties at end of employment



Employer 2


Phone


Dates Employed


From: To:

Address

City

State

Zip

Salary


Beginning:


Ending:


Name of Supervisor


Reason for leaving


Title & duties at beginning of employment


Title & duties at end of employment



Employer 3


Phone


Dates Employed


From: To:

Address

City

State

Zip

Salary


Beginning:


Ending:


Name of Supervisor


Reason for leaving


Title & duties at beginning of employment


Title & duties at end of employment



References

Give the name, address and phone number of three references not related to you.

Reference 1

Name and Occupation

Phone

Address

City

State

Zip


Reference 2

Name and Occupation

Phone

Address

City

State

Zip


Reference 3

Name and Occupation

Phone

Address

City

State

Zip


Special Skills and Qualifications

Check the equipment you are skilled at operating

Lift Truck
Table Saw
Radial Arm Saw
Panel Arm Saw
Planer
Band Saw
CRT
Calculator
Fax Machine
Computer/Word Processor (Typing)

List any additional equipment you can operate


Disclaimers

Check this box to signify that you have read and understood
the above "At Will" disclaimer.



Checking this box indicates that you have read and testify to the final disclaimer.



Call 800-493-2951 for more information today!