General Machine & Tool, Inc.: Employment

Application for Employment

Name

Social Security #

Address 1

Address 2

City

State

Zip Code

Phone

Fax

E-mail

Referred by

Position Applying for

Date you can start

Full Time
Part Time

Specify Hours:

Salary Desired

Is there any reason we may not inquire of your present employer or prior employers? If yes, please explain:

Have you ever applied to this company before? Yes or No
If yes, Where? When?

Are you willing to work overtime? Yes or No

Educational Information

Background	Name & Location of School	Highest Grade Completed	Major Area of Study
High School

College

Trade, Business or Graduate School

Do you have specialized technical and clerical skills?
(i.e. Equipment Operation, Special Tools or Machines Used, Computer Languages, Typing, Shorthand, Keypunch, etc.)

Employment History

Date Mo./Yr.	Name, Address and Phone # of Employer	Salary	Position	Name of Supervisor	Reason for Leaving
Fr.
To
Fr.
To
Fr.
To
Fr.
To

References

Name and Position	Company	Telephone Number
1.
2.
3.

If you have any questions or comments use the box below.

I hereby authorize the company to investigate all statements contained in this application and I authorize the release of such factual information without liability for any damages whatsoever to the giver or receiver thereof. I understand that misrepresentation or omission of facts called for in this application is cause for disciplinary action up to and including dismissal. I further agree to submit to a pre-employment physical exam, and in the event I am employed, to abide by all company policies and regulations, including periodic physical exams thereafter.