Employment Application - Parker Manufacturing, LLC

We are an Equal Employment Opportunity Employer. All Applicants are considered for employment based upon their qualifications, without regard to race, color, religion, sex, national origin, age, disability, martial, or veteran status.

Fields marked with * are required

* First Name

Middle Initial

* Last Name

Address

Apartment / Suite Number

City

State

Zip Code

Phone number

* Email Address

Social Security Number

Position Desired

Date You Can Start

Salary or Wage Desired

Have you been employed by this company before?

If yes, state: when, where, the position(s) you held and why you left

Do you know anyone who works here?

If yes, who?

How were you referred to the company?

Education and Training

Elementary and High School

What was your highest grade completed

Name and location of last school attended

College and Graduate School

How many years did you complete?

Names and locations of college(s) attended

Degrees received

Trade or Technical School

How many years did you complete?

Names and locations of school(s) attended

Degrees or certificate(s) received

Employment History

Beginning with your present or most recent employer, describe your employment history below:

Present or Last Employer

Name

Address

Phone

Nature of Business

Date Hired

Date Left

Starting Position

Starting Salary

Final Position

Final Pay

Describe your work and responsibilities

Reason for leaving or desiring to leave

If you are still employed, may we contact this employer at this time?

Next Previous Employer

Name

Address

Phone

Nature of Business

Date Hired

Date Left

Starting Position

Starting Salary

Final Position

Final Pay

Describe your work and responsibilities

Reason for leaving or desiring to leave

If you are still employed, may we contact this employer at this time?

Other Past Employers

If necessary, please include other past employers below

Special Skills

To the extent you have not already done so earlier in this application, summarize any special skills or qualifications you have which relate to the position for which you are applying

Miscellaneous Information

Have you ever been convicted of a crime, other than a minor traffic offense?

If yes, explain

A record of criminal conviction does not necessarily serve as a bar to employment.

If the position for which you are applying might require you to drive company vehicles, answer the following:

Do you have a valid driver's license?

If yes, state your driver's license number and the state from which you received it

Has your driver's license ever been suspended or revoked?

If yes, explain

Have you ever been cited for any moving violations in the last five years?

If yes, explain

References

Provide the name, address, and telephone number of three professional or personal character references who are not related to you

PLEASE READ THE FOLLOWING PARAGRAPHS CAREFULLY

I certify that all the information I have supplied on this application is true, accurate and complete to the best of my knowledge, and that I have not knowingly withheld any information which, if known to the company, would affect my application unfavorably. I understand that any false, misleading and/or incomplete statements on this application and/or in any interview, constitute sufficient cause for the company not to employ me, or if I am employed, to terminate my employment.

I authorize an investigation to be conducted concerning all of the information I have supplied on this application, and all other information which the company deems to be relevant to my qualifications for employment. I further authorize my present employer, any former employer, consumer reporting agency, any professional or personal reference, or any other appropriate source or individual to provide all information that is requested in connection with such investigation. I understand that if an investigative report is requested from a consumer reporting agency, I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of the nature and scope of the investigation requested. I release the company and all named and unnamed sources from any and all liability which may result from furnishing information concerning me.

This employment application will be considered active for ninety (90) days from the date below.

If I want to be reconsidered for the position with the company after this time, I will fill out a new application.

I agree to take any lawful examination or test, including any drug and/or alcohol test, required by the company as a condition of my being hired, or that my refusal to take any such lawful examination or test will constitute sufficient cause for the company not to employ me, or :if I am employed, to terminate my employment. I release the company and all other named and unnamed sources from any and all liability which may result from any lawful examination or test.

If I am employed, l agree that in consideration for my employment, will conform to the rules and regulations of the company. I understand that those rules and regulations may be altered, amended or repealed by the company at any time, at the company's sole option and without any prior notice to employees.

I acknowledge that if I am employed, my employment and compensation can be terminated at any time, with or without cause or notice, at the option of either the company or myself. I understand that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, to assure any benefits or terms and conditions of employment, or to make any agreement contrary to the foregoing.

* Please enter your initials below to signify that you have read and understand the information above.

* Security question: What is 4 + 5? (Spell out the answer...)