First Name * Last Name* Street Address * City* State* Zip Code* Phone* Email* If you are under 18 years of age, can you provide proof of your eligibility to work? *YesNo Have you ever filled an application with us before? If yes, when?* Available Start Date* Present Employment Status*EmployedSelf-EmployedUnemployedStudent Available to Work:*Full-TimePart-TimeTemporary Position you are applying for:* Are you able to perform the essential functions of the position you seek without accommodation? If you need clarification of the essential job functions of the position(s) you seek, please ask the interview. *YesNo Are you currently on “lay-off” status and subject to recall? *YesNo Can you lawfully work in the United States?*YesNo Have you been arrested for a Felony, or convicted of a Misdemeanor or Felony?*YesNo If so, please state citation, date and place where offense occurred. What do you consider to be your strongest skills? * Do you know anyone (friend, family, acquaintance) who is currently employed with us? If so, what is their position?* Highest Level of Education*4-Year Bachelor's Degree2-Year Associates DegreeHigh School Diploma/GEDSpecialized Training Please provide any additional information such as special skills, training, management experience, equipment operation or qualifications you feel will be helpful to us in considering your application. * Do you have Military Experience? *YesNo If yes, list branch and rank: If yes, were you Honorably Discharged? YesNo Current/Most Recent Employer* Date Started* Date Ended* Business Phone* Street Address* City** State** Zip* Last Position Held & Responsibilities* Reason for Leaving* Former Employer Name Date Started (Former Employer) Date Ended(Former Employer) Street Address(1) City(1) State(1) Zip(1) Business Phone (Former Employer) Last Position Held & Responsibilities (Former Employer) Reason for Leaving from Former Employer First Name (Reference 1)* Last Name (Reference 1)* Email (Reference 1)* Phone (Reference 1)* Relationship* Years Acquainted* First Name (Reference 2)* Last Name (Reference 2)* Email (Reference 2)* Phone (Reference 2)* Relationship (Reference 2)* Years Acquainted (Reference 2)* First Name (Reference 3)* Last Name (Reference 3)* Email (Reference 3)* Phone (Reference 3)* Relationship (Reference 3)* Years Acquainted (Reference 3)* EMERGENCY CONTACT: Name, Relationship* Emergency Contact Phone* City, State* Where did you hear about Petoskey Plastics? Social MediaNewspaperRadioFriend/FamilyCommunity EventTemp Service Upload Resume I understand that prior to being offered employment I may be requested to take an employment examination. I understand that prior to being offered employment I may be requested to take an employment examination. In the event that I have a disability that will affect my ability to take the test, I will so inform the Company prior to the test so that a reasonable accommodation can be made. The Company reserves the right to require medical documentation regarding the need for accommodation. I understand that prior to employment I will be required to submit a drug screen. I certify that the facts contained in this application are true, accurate, and complete to the best of my knowledge and understand that, if employed, falsified statements or omitted material facts on this application may result in my disqualification from consideration for employment, or termination from employment if I have been hired. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated with or without cause, at any time, with or without notice. This provision supersedes any oral or written representation to the contrary unless in writing and signed by both the President of the Company and the person to whom the writing is directed. I authorize investigation of all statements contained in this application for any employment-related purpose. I release the listed references and all employers, except those specifically excepted,* to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to the Company. By completing this job application, you agree to the above.*Yes, I agreeNo, I do not Submit There is no form selected or the form was deleted.
