Application - Waukesha Metal

Employment Application

Step 1 of 6 - Applicant Information

High School
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Years Completed:
Did you graduate?
- Yes
- No
Diploma/Degree
College
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Years Completed:
Did you graduate?
- Yes
- No
Diploma/Degree
Other
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Years Completed:
Did you graduate?
- Yes
- No
Diploma/Degree

Name
First Last
Relationship
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name
First Last
Relationship
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name
First Last
Relationship
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor
First Last
Job Title
Starting Salary
Ending Salary
Responsibilities
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor
First Last
Job Title
Starting Salary
Ending Salary
Responsibilities
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor
First Last
Job Title
Starting Salary
Ending Salary
Responsibilities
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No

Branch
From
Date Format: MM slash DD slash YYYY
To
Date Format: MM slash DD slash YYYY
Rank at Discharge
Type of Discharge
If other than honorable, explain:

I certify that the information contained in this application is correct to the best of my knowledge. I understand that, if hired for employment, any misstatement or omission of information on this application will be grounds for immediate termination. I hereby authorize Waukesha Metal Products to conduct an investigation of all statements contained in this application, including my response to the inquiry concerning any criminal conviction record, and understand that my employment is contingent upon satisfactory completion of such investigation. I further authorize the employers listed herein to give Waukesha Metal Products (the “Company”) any and all information concerning my previous employment and any pertinent information they may have, personal and otherwise, and I release all parties from liability for any damage that may result from furnishing that information to the Company. I understand that if I am offered a job position, I will be required, as a condition of employment, to submit to a physical exam and/or drug screening. I authorize Waukesha Metal Products to obtain a consumer report or an investigative consumer report concerning my background and credit and I understand that such report may be used as part of the process in considering my candidacy for employment. Pursuant to the Immigration Reform and Control Act of 1986, all applicants, upon being made an offer of employment, must produce documents, which are specified by the federal government, establishing their identity and authorization for employment in the United States. These documents must be produced no later than seventy-two hours after commencement. I understand that I will also be required to sign a Form I-9 (issued by the federal government) verifying, under oath, my employment authorization. I understand that, if I am hired, my employment shall be “at will” and can be terminated by the Company or me with or without cause, at any time, with or without notice. I further understand that, if I am hired, the terms and conditions of my employment, including compensation and benefits, can be changed at the discretion of the Company, upon notice to me. However, any alteration of the “at will” status of my employment or terms and conditions of my employment must be made in a written employment agreement signed by me and by the President/CEO of Waukesha Metal Products.
Type Name
Date
Date Format: MM slash DD slash YYYY