Employment Application - Accu-Precision

Personal Information

First Name*

Middle Name*

Last Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Are you 18 Years or Older?*

Yes
No

Desired Employment

Position Desired*

Date you can Start*

Desired Salary*

How did you learn about Accu-Precision?

Reason for interest in this position?

Education

School Level*

Name of School & Location*

Years Attended*

Subject Studied*

Did you graduate?*

Yes
No

School Level

Name of School & Location

Years Attended

Subject Studied

Did you graduate?

Yes
No

School Level

Name of School & Location

Years Attended

Subject Studied

Did you graduate?

Yes
No

References

Provide three references, unrelated to you, whom you have known for at least one year.

Name*

Phone*

Business*

Years Acquainted*

Name*

Phone*

Business*

Years Acquainted*

Name*

Phone*

Business*

Years Acquainted*

Yes No Questions for operating positions, such as Machinists and Inspectors

Are flexible working hours important to you?*

Yes
No

Are you willing to work overtime?*

Yes
No

Are you O.K. with fixed starting and stopping times?*

Yes
No

Are you O.K. working a 2nd shift from 3:00 pm to 1:00 am Monday - Thursday?*

Yes
No

Are you O.K. working a Weekend shift from 6:00 am to 6:30 pm Friday – Sunday?*

Yes
No

Do you like production jobs?*

Yes
No

Do you like prototype jobs?*

Yes
No

Select all machines/activities that you have mastered and can execute independently:

List any competitive activities that you are or have been involved in:

(Examples: High School Sports, Design Competitions, Debate, 5K or 10K Races etc.)

Activity

Accomplishments

Activity

Accomplishments

Activity

Accomplishments

Other Information

Additional Information

Please provide any additional information, accomplishments, or certifications that might be applicable to your ability or interest in performing the duties associated with the position.

Former Employers

List below your last three employers, starting with the most recent

Name of Employer*

Address*

Street Address Address Line 2 City State ZIP Code

Starting Date*

Ending Date*

Job Title*

Starting Pay*

Ending Pay*

May we contact your supervisor?

Yes
No

Name of Supervisor*

Title*

Phone*

Description of Work*

Reason for Leaving*

Name of Employer

Address

Street Address Address Line 2 City State ZIP Code

Starting Date

Ending Date

Job Title

Starting Pay

Ending Pay

May we contact your supervisor?

Yes
No

Name of Supervisor

Title

Phone

Description of Work

Reason for Leaving

Name of Employer

Address

Street Address Address Line 2 City State ZIP Code

Starting Date

Ending Date

Job Title

Starting Pay

Ending Pay

May we contact your supervisor?

Yes
No

Name of Supervisor

Title

Phone

Description of Work

Reason for Leaving

Have you been convicted of a felony within the last 3 years?*

Yes
No

If Yes, Explain

Authorization

Authorization*

“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE AND I UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE.”

Date*

Signature*

Accu-Precision is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Name

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