TEEMS FABRICATION INC.Employment Application Position * Name of position applying for Desired Salary * Enter desired salary Date of Application * MM DD YYYY Name * First Name Last Name Street Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * (###) ### #### Alternative Phone Number (###) ### #### Email * Employment Experience List the name of your present or previous employment in chronological order with present or most recent employer listed first. Be sure to account all periods of time. If self employed, give company name and supply business references. Phone Number (###) ### #### Name of Employer * First Name Last Name Supervisor May We Contact? Yes No Street Address Address 1 Address 2 City State/Province Zip/Postal Code Country Dates Employed (From - To) From * MM DD YYYY To * MM DD YYYY Job Title * Reason for Leaving * Employment Experience * All other Job Details, if any write down below Have you ever been involuntarily terminated or asked to resign from any job? * Yes No If yes, explain. Explain any gaps in your employment history * List any other experience, job-related skills, additional languages, or other qualifications that you believe should be considered. Education Describe your educational background High school School Name Area of study/ major Intermediate or College Education College Name Area of Study (Major) University Education University Name Area of Study (Major) Professional School / Trade School Specialized Training, Skills, or Extracurricular Activities Any Other Education Military Service Branch From Date of Enrollment MM DD YYYY To Date of Retirement MM DD YYYY Rank at Discharge Type of Discharge Any Other Honorable, Explain References List three references Reference 1 Title & Name Relation Phone No (###) ### #### Email Reference 2 Title & Name Relation Phone No (###) ### #### Email Reference 3 Title & Name Relation Phone No (###) ### #### Email General Information Have you ever used another name? * Yes No Is any additional information relative to name changes, use of an assumed name, or nickname necessary to enable a check on your work and educational record? * Yes No If yes to either of the above, explain: a Have you ever worked for this company before? * Yes No If yes, provide dates and position: Do you have friends and/or relatives working for this company? * Yes No If yes, name(s) and relationship(s): On what date are you available to begin work? MM DD YYYY Days/hours available to work: Monday * Hours Available to Work Tuesday * Hours Available to Work Wednesday * Hours Available to Work Thursday * Hours Available to Work Friday * Hours Available to Work Saturday * Hours Available to Work Sunday * Hours Available to Work Are you available to work? * Full Time Part Time Night Shift If hired, do you have a reliable means of transportation to and from work? * Yes No Are you at least 18 years old? * Note: If under 18, hire is subject to verification that you are of minimum legal age. Yes No If hired, can you present evidence of your identity and legal right to work in this country? * Yes No Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation? * Yes No Do you consent to a pre-employment drug screening? * Yes No My signature attests to the fact that I have read, understand, and agree to all of the above terms. * Yes No Signature * Your Full Name Date MM DD YYYY Thank you!
