General Application for Employment

General Info

How did you learn about us?*

Position(s) Applied For:*

Full Name*

Address

Phone #*

A valid phone number is required.

Social Security*

Email*

A valid email address is required.

If under the age of 18, can you provide required proof of your eligibility to work?*

Yes No

Have you ever filed an application and/or been employed with us before?*

Yes No

Are you legally eligible for employment in this country?*

Yes No

Are you currently employed?*

Yes No

if yes, may we contact your current employer?*

Yes No

Date available for work:*

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

Yes No

Are you available to work...*

Full-time Part-time Temporary

Employment History

Start and End Dates:*

Employer*

Job Title*

Telephone Number*

A valid phone number is required.

Supervisor's Name*

Reason for Leaving*

Job Responsibilities*

Hourly Rate/Salary (Starting and Ending)

Special Skills and Qualifications

Please summarize any special job-related skills and/or qualifications*

Educational Background

Highschool

Highschool Name & Location*

Years Completed*

Did you Graduate Highschool?*

Yes No

College

College Name & Location*

Course of Study*

Did you Graduate College?*

Yes No

Reference 1

1) Name*

1) Telephone*

A valid phone number is required.

1) Years Known*

Reference 2

2) Name

2) Telephone

A valid phone number is required.

2) Years Known

Reference 3

3) Name

3) Telephone

A valid phone number is required.

3) Years Known

Accommodations

Are you physically and otherwise able to perform the functions of the job for which you are applying with or without an accommodation(s)?*

Yes No

If Accommodations are required, please list the accomodations, and a brief description of how they would assist you in performing the job functions*

If hired, you will be required to provide prior written request for accommodation to your immediate supervisor.

I certify that answers given herein are true and complete to the best of my knowledge.

This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Signature of Applicant*

Date*

General Application for Employment

ACI Plastics

Apply Online

General Info

Employment History

Special Skills and Qualifications

Educational Background

Highschool

College

Reference 1

Reference 2

Reference 3

Accommodations

If hired, you will be required to provide prior written request for accommodation to your immediate supervisor.

I certify that answers given herein are true and complete to the best of my knowledge.

This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

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