SUPERIOR FABRICATION EMPLOYMENT APPLICATION

17499 South Dolan; Kincheloe MI 49788
Equal Oppurtunity Employer
This company is an equal opportunity employer and will not discriminate against any applicant on the basis of any characteristic that is protected by State or Federal Law. Michigan law requires that a person with a disability or handicap requiring accommodation to perform the essential duties of a job, notify the employer in writing within 182 days of the date that the need is known or should have been known.

* Required Field

PERSONAL DATA

* First Name

Middle Initial

* Last Name

Maiden Name

Phone

E-mail Address

Street Address

City/State/Zip

How did you find out about this job?

Minimum Salary Expected

Are you at least 18 years old?
Yes
No
Driver’s License Number

State Issued

Expiration Date

Are you legally eligible for employment in the U.S.?
Yes
No
Proof of U.S. citizenship or immigration status will be required if hired.
Have you been convicted of a crime?
Yes
No
State the nature of the offense and disposition of the case. Include dates and places. (NOTE: The existence of a criminal record does not constitute an automatic bar to employment.)




EMPLOYMENT DATA

Status
Full Time | Part Time | Temporary
Which position are you applying for?

Which hours and shift(s) would you prefer to work?

Which hours and shift(s) would you prefer NOT to work?

Would you like to work weekends?
Yes
No
Would you like to work holidays?
Yes
No
Are you currently employed?
Yes
No
If hired, when would you be able to start?

Have you ever worked for Superior Fabrications?
Yes
No
What name did you use when you were last employed with Superior Fabrications?


List any friends or relatives employed by this company

Are you on layoff and subject to recall?
Yes
No
Have you ever been discharged or asked to resign from any position?
Yes
No
Please explain the reason for discharge or resignation


How many days have you missed from school or work within the last year other than approved vacation, sick, or disability leave?

How many days have you been late from school or work within the last year other than approved vacation, sick, or disability leave?

Are you able to perform all the tasks for the job you are applying for?
Yes
No
Please explain why you can not perform the tasks for the job you are applying for



EDUCATION HISTORY

High School or Equivalent Name


Did you graduate?
Yes
No

College #1

Name

Address

Highest Degree Obtained

Major

Minor

Date Attended

Date Graduated

College #2

Name

Address

Highest Degree Obtained

Major

Minor

Date Attended

Date Graduated

College #3

Name

Address

Highest Degree Obtained

Major

Minor

Date Attended

Date Graduated

Professional Licenses #1

Name

State Issued


Expiration Date


Professional Licenses #2

Name

State Issued


Expiration Date


Professional Licenses #3

Name

State Issued


Expiration Date


List any other certifications or ther specialties


MILITARY HISTORY

Are you a veteran?
Yes
No

Date Served From:


Date Served To:


List any special skills or training:




EMPLOYMENT HISTORY

Employer #1

Company Name


Phone Number


Address


City, State, Zip


Date Employed From


Date Employed To


Beginning Salary


Ending Salary


Job Title:


Supervisor`s Name & Title


May we contact this person?

Yes
No

Why not?

Describe Duties


Specific Reason for Leaving

Employer #2

Company Name


Phone Number


Address


City, State, Zip


Date Employed From


Date Employed To


Beginning Salary


Ending Salary


Job Title:


Supervisor`s Name & Title


May we contact this person?

Yes
No

Why not?

Describe Duties


Specific Reason for Leaving

Employer #3

Company Name


Phone Number


Address


City, State, Zip


Date Employed From


Date Employed To


Beginning Salary


Ending Salary


Job Title:


Supervisor`s Name & Title


May we contact this person?

Yes
No

Why not?

Describe Duties


Specific Reason for Leaving

Employer #4

Company Name


Phone Number


Address


City, State, Zip


Date Employed From


Date Employed To


Beginning Salary


Ending Salary


Job Title:


Supervisor`s Name & Title


May we contact this person?

Yes
No

Why not?

Describe Duties


Specific Reason for Leaving

How many jobs have you had in the last five years not listed above?


Why are you seeking a new position at this time?


List any business-related outside interests and organizations you’re active in



Applicant Statement. Please read the following carefully, then check accept and date the application.

I certify that the information contained in this application is true and correct to the best of my knowledge and understand that false or misleading information in this application or interview(s) will result in discharge. I further understand that the company requires a pre-employment physical examination and drug screen by a Company designated source and employment is contingent upon receipt of a satisfactory medical evaluation and negative drug screen results. I further understand that a designee of Superior Fabrication Company LLC will receive the medical evaluation detail and drug screen results. I understand that this application is not an offer or a contract of employment. I also understand and agree that if Superior Fabrication Company LLC employs me, such employment will not result in a contract for employment. In consideration of my employment, I agree to conform to the rules and regulations of the company and understand that me employment and compensation can be terminated, with or without cause and with or without notices, at any time at the option of either the Company or myself. I further understand that nothing contained in any documents published by the Company shall in any way modify the foregoing, and that it cannot be modified in any way by any oral or written representations made by anyone employment by the Company except by a written document signed by the President of the Company. I hereby authorize law enforcement organizations, educational institutions, and references to furnish any and all information concerning my personal character, habits and employment records and release all such persons from liability and damages as a result of such inquiries.


* I agree to the above statement.