General Information

Position(s) applied for*

Date of application*

Full Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Type of employment desired*

Shift preference*

If you are under 18, and it is required, can you furnish a work permit?

Yes
No

If NO, please explain

Have you ever been employed here before?*

Yes
No

If YES, gives position and dates

Are you legally eligible for employment in this country?*

Yes
No

Desired Salary*

Date Available For Work*

Are you able to meet the attendance requirements of the position?*

Yes
No

Do you have a driver’s license?*

Yes
No

If not, do you have reliable transportation? Please explain.

Have you ever pled "guilty" or "no contest" to, or been convicted of a crime?*

Yes
No

If YES, please provide date(s) and details

Answering "Yes" to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

Employment History

Provide the following information of your past three (3) Employers, assignments or volunteer activities, starting with the most recent.

Are you currently employed?

Yes
No

May we contact current and previous Employers before you are offered a position?

Yes
No

Employer Name:

Employer Phone:

Supervisor:

Job Title:

Dates Employed:

Hourly Rate/Salary:

Duties:

Reason for Leaving:

Employer Name:

Employer Phone:

Supervisor:

Job Title:

Dates Employed:

Hourly Rate/Salary:

Duties:

Reason for Leaving:

Employer Name:

Employer Phone:

Supervisor:

Job Title:

Dates Employed:

Hourly Rate/Salary:

Duties:

Reason for Leaving:

Skills and Qualifications

Describe any metalworking or manufacturing experience you have. Please include specific machines you have operated and/or any specific tools or measuring devices you have used. Also, include any training or certificates you have received that may qualify you for performing job-related functions in the position for which you are applying.

Describe a position you have had or an interest you have that you feel would make Leverwood a good choice for employment for yourself.

Educational Background

High School Name

If not a High School graduate, do you have a GED?

Yes
No

Did you graduate?

Yes
No

# of years completed

College Name

Course of Study

# of years completed

Did you graduate?

Yes
No

Trade, Business, or Correspondence School

Course of Study

# of years completed

Did you graduate?

Yes
No

Personal References

Name:

Phone:

# of years known

Applicant Statement

I certify that all of the information provided in this employment application is true and complete to the best of my knowledge, and I authorize investigation of all statements contained in this application, including a criminal background, credit history check, and drug test, as applicable. I understand that any false or incomplete information may disqualify me from further consideration for employment and may result in my immediate discharge if discovered at a later date. I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current Employer, past Employers, and other organizations to provide information concerning my previous employment and other relevant information that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.*

Yes
No

Email

This field is for validation purposes and should be left unchanged.

Currently Hiring!

Position Descriptions:

Employment Application

General Information

Employment History

Skills and Qualifications

Educational Background

Personal References

Applicant Statement