Sander ASSEMBLER Q.C. Inspector Admin Assistant RECEIVING ASSOCIATE FINISH ROOM MANAGER

Application

We offer equal employment opportunity to all based upon individual merit & without regard to race, color, religion, or national origin.

Position:^*

Applicant Information

First Name:^*	Middle:^*		Last Name:^*
Address:^*			Email:^*
City:^*	State:^*		Zip Code:^*
Telephone:^*	Shift Work:	YesNo	Salary Requirements:

Employment History

Employer Name:	Phone:
Address:
City:	State:	Zip Code:
Supervisor Name:	Supervisor Title:
Date Hired:	Terminated:
Job Title:	Final Wage:
Your Duties/Skills:
Why did you leave?:

Employer Name:	Phone:
Address:
City:	State:	Zip Code:
Supervisor Name:	Supervisor Title:
Date Hired:	Terminated:
Job Title:	Final Wage:
Your Duties/Skills:
Why did you leave?:

Employer Name:	Phone:
Address:
City:	State:	Zip Code:
Supervisor Name:	Supervisor Title:
Date Hired:	Terminated:
Job Title:	Final Wage:
Your Duties/Skills:
Why did you leave?:

Education

High School Name:		Year Graduated:
Trade School Name:		Year Graduated:
Degree/Studied:
College/Vo-Tech:		Year Graduated:
Degree/Studied:
Other Special Training or Education:

Additional Information

Are you at least 18 years of age? YesNo

Have you ever been convicted of a crime(s)? YesNo
If yes, explain the nature of the offense, date, and penalty:

Do you possess a valid driver's license? YesNo

Do you have any relatives in our employ? YesNo
If yes, give name(s), relationship(s), and work locations(s):

Have you ever worked for or applied to Sorrentino Mariani & Co. before? YesNo
If yes, give date and type of work applied for:

Is there any legal reason why you cannot be employed in this country? YesNo
If yes, explain:

IMPORTANT - READ THE FOLLOWING CERTIFICATION AND AGREEMENT CAREFULLY BEFORE SUBMITTING THIS FORM.

In making this application for employment, I certify that the statements I have made are true, complete and correct, and I agree that any willfully false statements or misrepresentations herein, whenever discerned, are just cause for Sorrentino Mariani & Company either to refuse or to terminate my employment. Further, I authorize any school or former employer to disclose to Sorrentino Mariani & Company upon request any information they may have as to my record, performance, and attendance and will hold such schools and employers harmless for such disclosure. I agree to take the required drug-screening test, if required. I understand that this application becomes void after 30 days unless renewed personally or in writing by me. I have read and do understand and subscribe to this certification and agreement.

In consideration of my employment, I agree to conform to the rules and regulations of Sorrentino Mariani & Company. I also agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at my option or at the option of Sorrentino Mariani & Company. I understand that no employee or representative of Sorrentino Mariani & Company, other than the chairman of the board or the senior vice president, human resources and administration has any authority to enter into any agreement guaranteeing my employment for any specified period of time, nor to make any agreement contrary to the foregoing.

I have carefully read and agreed to the above conditions.