28 Westland Drive

Bad Axe, MI, 48413

(989) 269-8171

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Employment Request

Are you an apprentice or journeyman? Fill out our employment request form below. Thank you for your interest in working with us!

We’re currently hiring!

Personal Information

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Referred By

Employment Desired

High School

Please include name and location.

Did You Graduate?

Yes

Subjects Studied

College

Please include name and location.

Did You Graduate?

Yes

Subjects Studied

Trade, Business, or Correspondence School

Please include name and location.

Did You Graduate?

Yes

Subjects Studied

General Information

Subject of Special Study/Research Work

Special Training

Special Skills

U.S. Military or Naval Service

Branch & Rank

Former Employers

Name of Employer #1

Address of Employer #1

Position

Salary

Reason for Leaving

Name of Employer #2

Address of Employer #2

Position

Salary

Reason for Leaving

Name of Employer #3

Address of Employer #3

Position

Salary

Reason for Leaving

References

Name

Address

Business

Years Known

Name

Address

Business

Years Known

Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into an agreement for employment for any specified period of time or to make any agreement to the contrary to the foregoing unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment." In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

Date

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Name

Typing your name below is your digital signature for the authorization above.

Employment Request

We’re currently hiring!

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