ATTC Employment Application

PERSONAL INFORMATION

Name*

Date (Format: MM-DD-YYYY)*

Email*

Phone Number*

Present Address:

Street Address*

City*

State*
—Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Zip*

Are you 18 years or older?*
YesNo

In order to permit a check of your work and education records, are there any other names that you have previously used?*
YesNo

If yes, identify name(s) and relevant date(s):

Please list all previous places of residence (if different than current residence) for the past three years (Use a separate sheet if more than three):

GENERAL EMPLOYMENT QUESTIONS

How did you learn about us?*
AdvertisementFriendWalk-InWeb PageEmployment AgencyRelativeATTC EmployeeFacebook/Social MediaOther

If you learned about us through an ATTC Employee or other, then please specify:

Position applied for:*

Can Start: (Format: MM-DD-YYYY)*

Are you employed now?*
YesNo

If so, may we contact your present employer?
YesNo

If no, then please explain reason:

Have you ever applied to or worked for ATTC Manufacturing, as an employee or contractor?
YesNo

If so, when were you employed?

Are you currently able to be employed lawfully in this country? (Note that proof of citizenship or immigration status will be required upon employment.)*
YesNo

Are you currently on "lay-off" status and subject to recall?
YesNo

If yes, please explain:

Can you travel if the job requires it?*
YesNo

Type of Employment Desired?*
Full-TimeCollege Help

Hours of Availability (Please check all that apply)*
DaysEveningsWeekends

Can you work mandatory overtime?*
YesNo

If you are under the age of 18, can you furnish a work permit, if required?
YesNo

EDUCATION

Elementary:

Name and Location of School

Number of Years Attended

Did You Graduate?
YesNo

Subjects Studied/Degree

High School:

Name and Location of School

Number of Years Attended

Did You Graduate?
YesNo

Subjects Studied/Degree

College:

Name and Location of School

Number of Years Attended

Did You Graduate?
YesNo

Subjects Studied/Degree

Graduate/Professional:

Name and Location of School

Number of Years Attended

Did You Graduate?
YesNo

Subjects Studied/Degree

Trade, Business or Other:

Name and Location of School

Number of Years Attended

Did You Graduate?
YesNo

Subjects Studied/Degree

MILITARY SERVICE

Military Service

Rank

FORMER EMPLOYERS

Please give an accurate, complete full-time and part-time employment record. Include any job-related military service assignments and volunteer activities. Start with your current employer (or most recent employer if not employed) and account for all periods of unemployment. Use a separate sheet if necessary.

Employer Information (1):

Employer

Address/Phone

Position

Supervisor's Name

Reason for Leaving

Voluntary or Involuntary Termination?
VoluntaryInvoluntary

Employed From (Format: MM-DD-YYYY)

Employed To (Format: MM-DD-YYYY)

Starting Wage/Salary

Final Wage/Salary

Work Performed

Employer Information (2):

Employer

Address/Phone

Position

Supervisor's Name

Reason for Leaving

Voluntary or Involuntary Termination?
VoluntaryInvoluntary

Employed From (Format: MM-DD-YYYY)

Employed To (Format: MM-DD-YYYY)

Starting Wage/Salary

Final Wage/Salary

Work Performed

Employer Information (3):

Employer

Address/Phone

Position

Supervisor's Name

Reason for Leaving

Voluntary or Involuntary Termination?
VoluntaryInvoluntary

Employed From (Format: MM-DD-YYYY)

Employed To (Format: MM-DD-YYYY)

Starting Wage/Salary

Final Wage/Salary

Work Performed

Employer Information (4):

Employer

Address/Phone

Position

Supervisor's Name

Reason for Leaving

Voluntary or Involuntary Termination?
VoluntaryInvoluntary

Employed From (Format: MM-DD-YYYY)

Employed To (Format: MM-DD-YYYY)

Starting Wage/Salary

Final Wage/Salary

Work Performed

QUALIFICATIONS FOR EMPLOYMENT

Except for vacations and holidays, how many work days were you absent during the past calendar year?*
0-5 days6-10 days11-15 days16-20 days21+ days

Which of your previous jobs did you like best?*

What did you like most about that job?*

We have a policy of assuring that the work environment is free from harassment and discrimination. Have you ever been accused of sexual or other harassment or employment discrimination?*
YesNo

If yes, please explain:

Describe any specialized training, apprenticeship, and skills and state where it was received; also describe any job-related extra-curricular activities:

List professional, trade, business or civic activities and offices held. (You may exclude membership that would reveal gender, race, religion, genetic information, national origin, age, disability or any other protected status):

PERSONAL REFERENCES

(Give the names of three persons not related to you, whom you have known at least one year. Do not include any prior employer.)

Personal Reference (1):

Name*

Address*

Relationship*

Years Acquainted*

Area Code/Phone Number*

Personal Reference (2):

Name*

Address*

Relationship*

Years Acquainted*

Area Code/Phone Number*

Personal Reference (3):

Name*

Address*

Relationship*

Years Acquainted*

Area Code/Phone Number*

OTHER

In case of Emergency Notify:

Name*

Address*

Phone*

Have you ever plead guilty to or no contest to a crime or been convicted of a crime that has not been expunged?* Note: A conviction does not constitute an automatic bar to employment - the type of conviction, when it occurred, and other factors will be considered.
YesNo

If yes, please explain:

If hired, would you be able to perform all functions and all necessary job assignments of the particular job for which you are applying?*
YesNo

If no, please explain:

RESUME

Please upload your resume using the button below.

CERTIFICATION

I hereby authorize the release of any employment data relevant to my employment with ATTC Manufacturing, Inc. (Company) for the purpose of an employment investigation. I authorize a thorough investigation of my past employment, activities, and background and agree to cooperate in such investigation, and release from all liability or responsibility all persons and corporations requesting or supplying such information. This investigation may also include a determination regarding whether I have a criminal record.

I agree to submit to any lawful drug, alcohol, or other testing that may be required as a condition of employment or continued employment and understand that refusal to promptly submit and cooperate with such testing prior to or during the course of my employment will result in disqualification from consideration for employment or, if hired, termination.

I fully understand that if employed, any misrepresentation or omission on this Application or any other Company record will result in dismissal, regardless of the date of discovery. I acknowledge that employment is also subject to a satisfactory review of my references.

Neither this Application nor any statement made to me during the hiring process or thereafter shall be considered a contract of employment of any kind. Where such a contract is intended, I understand that it will be separately entered into and signed by the President of the Company. Absent such a contract, I understand that, if hired, my employment will be terminable-at-will, with or without a cause or notice, that I am not being employed for any specified or definite period of time, and that this application is not and is not intended to be a contract, offer, statement or confirmation of or for continued employment. I understand that any employee handbook or manual does not represent an employment contract if I am hired. I understand that the Company may alter, modify, amend, or terminate any of its policies and benefits, both as to active and retired employees.

I accept the above certification statement.

Date (Format: MM-DD-YYYY)*

E-Signature*

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