Madison County Wood Products Application For Employment

Personal Information

Name:*
E-mail:
Social Security Number:*
Present Address:
Permanent Address:
Phone No:
-
Are You 18 Years Or Older?

Are you prevented from lawfully becoming employed 
in this country because of Visa or Immigration Status?

Employment Desired

Position:*
Are you employed Now?
If So, may we inquire of your present employer?
Date You Can Start:*
Ever Applied To this company before?
If so, When and Where?
Salary Desired:*
Referred by:

Education

Grammar School Name & Location:
Graduate Grammar School?
#Years Attended Grammar School:
Subjects Studied Grammar School:
High School Name & Location:
Graduate High School?
#Years Attended High School:
Subjects Studied High School:
College Name & Location:
Graduate College?
#Years Attended College:
Subjects Studied College:
Trade, Bussisness or Correspndence Shool Name & Location:
Graduate Trade School?
#Years Attended Trade School:
Subjects Studied Trade School:
Subjects Of Special Study or Research Work:
Special Skills:
Activities (Civic, Athletic, Etc.):
Military Service:
Branch and Rank:
Present Membership in National Guard or Reserves

Former Employers
(List below last three employers starting with most recent First.)

Employer 1 Name & Address:
Emp 1 Date (From - To):
-
Reason for Leaving Employment 1:
Salary Employment 1:
Position Employment 1:
Employer 2 Name & Address:
Employment 2 Date (From - To):
-
Reason for Leaving Employment 2:
Salary Employment 2:
Position Employment 2:
Employer 3 Name & Address:
Employment 3 Date (From - To):
-
Reason for Leaving Employment 3:
Salary Employment 3:
Position Employment 3:
WHICH OF THESE JOBS DD YOU LIKE BEST?
WHAT DD YOU LIKE MOSTABOUT THIS JOB?

REFERENCES

GIVE THE NAMES OF THREE PERSONS NOT RELATED TO YOU WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.

Reference 1 Name:
Reference 2 Name:
Reference 3 Name:
Reference 1 Address:
Reference 2 Address:
Reference 3 Address:
Reference 1 Business:
Reference 2 Business:
Reference 3 Business:
Years Aquainted Reference 1:
Years Aquainted Reference 2:
Years Aquainted Reference 3:
Reference 1 Phone:
Reference 2 Phone:
Reference 3 Phone:

Emergency Contact

Emergency Contact Name:
Emergency Contact Address:
Emergency Contact Phone:
-

"I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAYBE REJECTED AND, IF I AM EMPLOYED, MY EMPLOYMENT MAYBE TERMINATED AT ANY TME.

IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE COMPANY'S RULES AND REGULATIONS, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANYTIME, AT EITHER MY OR THE COMPANY'S OPTION.  I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITIONS OF MY EMPLOYMENT MAYBE CHANGED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANYTIME BY THE COMPANY.  I UNDERSTAND THAT NO COMPANY REPRESENTATIVE, OTHER THAN IT'S PRESIDENT, AND THEN ONLY WHEN IN WRITING AND SIGNED BY THE PRESIDENT, HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING."

Signature Date:*
Application Verification Signature:

This form has been revised to comply with the provisions of the Americans with Disabilities Act and the final regulations and interpretive guidance promulgated by the EEOC on July 26, 1991.

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