Application For Employment

Name:

first

middle

last

Address:

city

state

zip

Home Phone:

Other phone:

if work phone, ok to call at work?	yes
	no

Email Address:

Referral Source:

Agency:

Mass Precision Employee:

Other:

List Date Previously Employed Here:

List names of relative working at Mass Precision Sheetmetal, Inc. if any:

EMPLOYMENT DESIRED
List position you are applying for & experience, if any.

Job title:

Experience:

years

months

Are you authorized to work in the USA?

yes no

Date you can start:

Salary Desired:

If required, can you work weekends?

yes no

Which shift(s) are you willing to work?

days swing graveyard

Do you want to work:

part-time full-time

LIST COLLEGE, UNIVERSITY and PART-TIME STUDIES,
Vocational, military and other training (include current)

NAME AND LOCATION	degrees (type)	COURSE OF STUDY

Summarize skills and equipment experience you acquired from employment or other experience (office machines, computer equipment, tools, etc.) and include any other information you think would be helpful to us in considering us for employment.

LIST THREE PROFESSIONAL REFERENCES WE MAY CONTACT:

NAME	company	title	day phone number

EMPLOYMENT EXPERIENCE
Even if you have a resume, please complete this section.

Failure to fully complete this portion of the application may remove you from further consideration. List all periods of employment and unemployment for past ten years.

Dates employed:

Employer:

Address:

city

state

zip

Phone:

Supervisor's Name:

Job Title:

Work Performed:

Reason for Leaving:

Pay:

Start: Finish:

Dates employed:

Employer:

Address:

city

state

zip

Phone:

Supervisor's Name:

Job Title:

Work Performed:

Reason for Leaving:

Pay:

Start: Finish:

Dates employed:

Employer:

Address:

city

state

zip

Phone:

Supervisor's Name:

Job Title:

Work Performed:

Reason for Leaving:

Pay:

Start: Finish:

Dates employed:

Employer:

Address:

city

state

zip

Phone:

Supervisor's Name:

Job Title:

Work Performed:

Reason for Leaving:

Pay:

Start: Finish:

QUESTIONNAIRE - Please answer questions below and give details to "yes" answers.

1. Have you ever been discharged for cause by a former employer?

yes no

2. Have you ever been convicted of a felony?

yes no

Details For
"Yes" Answers:

For positions that require driving a company vehicle, a current DMV printout will be requested if you are scheduled for an interview.

I UNDERSTAND THAT EMPLOYMENT AT MASS PRECISION SHEETMETAL, INC. WILL BE GOVERNED BY THE TRADITIONAL RULES OF "AT WILL" EMPLOYMENT, WHICH MEANS THAT MASS PRECISION SHEETMETAL, INC. OR I HAVE THE RIGHT AT ANY TIME TO TERMINATE THE EMPLOYMENT RELATIONSHIP. I AUTHORIZE INVESTIGATIION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. I UNDERSTAND THAT MISREPRESENTATIONS OR OMISSION OF FACTS CALLED FOR MAY BE CAUSE FOR REJECTION OR APPROPRIATE ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT.

INVITATION TO IDENTIFY FOR AFFIRMATIVE ACTION PURPOSES

MASS Precision, Inc. is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, sex, national origin, age, disability, or any other basis prohibited by federal, state, or local law. No question on this form is intended to secure information to be used for such discrimination. The company is required by federal regulations to report information as requested below. Your contribution of this information is completely voluntary and in no way affects the decision regarding your employment opportunity. The information you provide is strictly confidential and will be maintained separate from your application form.

This form will be kept in a confidential file separate from your application for employment.

Name:

first

last

Position
Applied For:

Date Applied :

Gender Identification (check one)

FEMALE

MALE

Race/Ethnic Identification (check one):

Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

If you did not check “Hispanic or Latino” above, please select one of the following race/ethnic identifications.

White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.

	I accept these terms.
	I do not accept these terms.

Please confirm this submission by entering the two words below.