Atlas Welding and Fabrication

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Application for Employment

Step 1 of 8

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Personal Information
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Phone
Are you 18 years or older?
- Yes
- No
Are you either a U.S. citizen or an alien authorized to work in the United States?
- Yes
- No
Do you have a valid drivers license?
- Yes
- No

Emplyoment Desired
Position
Date You Can Start
MM slash DD slash YYYY
Salary Desired
Are you employed now?
- Yes
- No
May we inquire of your present employer?
- Yes
- No
Ever applied to this company before?
- Yes
- No
When?
Where?
Referred by

Education
Grammar school name and lcation
No. of year attended*
Did you graduate?*
- Yes
- No
Subjects Studies
High school name and lcation
No. of year attended*
Did you graduate?*
- Yes
- No
Subjects Studied
College name and lcation
No. of year attended*
Did you graduate?*
- Yes
- No
Subjects Studied
Trade, Business, or Correspondence school name and lcation
No. of year attended*
Did you graduate?*
- Yes
- No
Subjects Studied

General
Subjects of special study or research work
Special Skills
Activities: (civic, athletic, etc.)
U.S. Military or Naval Service
Rank
Present Membership in National Guard or Reserves

Former Employers (list below last three employers, starting with last one first)
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Name and address of employer
Salary
Position
Reason for leaving

From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Name and address of employer
Salary
Position
Reason for leaving

From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Name and address of employer
Salary
Position
Reason for leaving

References
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Business
Years Acquainted
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Business
Years Acquainted
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business
Years Acquainted

787

*The Age Discrimination in Employment Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.

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