Wylie Steel Fabricators, Inc.

Application for Employment

Date

Full Name

Address

City

State AL v AZ AR CA CO CT DE DC FL GA HI ID IL IA KS KY LA ME MD MA MI MN MS MO MT MT NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN v TX VT VA WA WA WI WY

Zip

Social Security Number

Phone Number

Positions Applied for
1. 2.

Hours or shift preferred

Date available to start work

Specify restrictions, if any, of days and hours (e.g. class schedule)

Type of work Full Time Part Time Temporary

Minimum compensation requirement
$

Are you at least 18 years of age?Yes No

Are you authorized to live and work in the United States? Yes No

Have you ever been convicted of a felony? Yes No

Are you able to perform the essential functions of the job for which you have applied? Yes No

Clerical Skills/Computer Skills

Typing Speed

Keyboard Skills (Data Entry)

List any additional skills, education or training related to the position applied for

Record of Education

High School Name

High School Address

High School Course of Study

High School Year Completed 1 2 3 4

Did you graduate high school Yes No

College Name

College Address

College Course of Study

College Year Completed 1 2 3 4

Did you graduate college Yes No

Other School Name (specify)

Other School Address

Other School Course of Study

Other School Year Completed 1 2 3 4

Did you graduate college Yes No

Employment History

Present or Most Recent Employer

Address

Dates Employed
From: To:

Name of Supervisor

Weekly Pay

Job Title and Responsibilities

Reason for Leaving

May we contact? Yes No

Previous Employer

Address

Dates Employed
From: To:

Name of Supervisor

Weekly Pay

Job Title and Responsibilities

Reason for Leaving

May we contact? Yes No

Previous Employer

Address

Dates Employed
From: To:

Name of Supervisor

Weekly Pay

Job Title and Responsibilities

Reason for Leaving

May we contact? Yes No

References
List two references, home telephone numbers and years known. (Do not include relatives of employers.)

Name of Reference

Relationship

Telephone Number

Years Known

Name of Reference

Relationship

Telephone Number

Years Known

Employment Conditions - Read Carefully

By my signature below, I certify that all information provided on this application is true and accurate. I understand that any false statements, misrepresentation, or omissions made on this application will exclude me from consideration for employment or subject me to discipline up to and including termination from Wylie Steel Fabricators, Inc. I understand that employment with Wylie Steel Fabricators, Inc. is ?at will? and therefore for an indefinite period of time. If employed, I may terminate my employment at any time and the Employer may terminate or modify the employment relationship at any time with or without notice or cause. I understand that I am not guaranteed a specific shift, schedule or work assignment and I may be expected to work overtime. If employed by Wylie Steel Fabricators, Inc., I will abide by its rules, regulations, policies and procedures. I hereby authorize all individuals and organizations named or referred to on this application to answer all questions that may be asked and give all information that may be sought in connection with this application. This may include, but is not limited to: work history, criminal records, licensure, certification, education, and driving record. I also certify that any individual or organization furnishing information concerning me shall not be held accountable for giving this information. I hereby release said individuals and organizations from any and all liability, which may be incurred as a result of furnishing such information.

I understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment. Finally, I freely and voluntarily agree to undergo drug testing as part of the application process, or at any time during my employment with Wylie Steel Fabricators, Inc. I understand that either refusal to submit to the test or failure of the test per Wylie Steel Fabricators, Inc. policy will disqualify me from consideration and/or continuation of employment.

I agree with the employment conditions

Wylie Steel Fabricators, Inc. is an Equal Opportunity Employer and does not discriminate on the basis of race, color, age, sex, religion, national origin, disability, marital status, or any other characteristic protected by law. Wylie Steel Fabricators, Inc. is a no-smoking facility in compliance with the Tennessee Non-Smoker Protection Act.