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EMPLOYMENT

Open Positions:

Factory Technician

Application Form:

Step 1 of 3

33%

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Position Applying For*
- Factory Technician
- Accounting
- Inside Sales
Are you legally authorized to work in the United States?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
Please explain your felony conviction*
EDUCATION
Highest Level Completed*
Date Completed*
MM slash DD slash YYYY
AVAILABILITY
Days Available*
- Select All
- Sunday
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
Shift Preference*
Swing shift is 3PM to Midnigt
Night Shift is 12 Midnight to 9AM
- Days
- Swing
- Night

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EMPLOYMENT HISTORY

Employer 1 (E1)
E1 Name
E1 Address
E1 Phone
E1 Start Date
MM slash DD slash YYYY
E1 End Date
MM slash DD slash YYYY
Your Position at E1
Your Supervisor/Manager at E1
E1 Supervisor/Manager Phone
May we contact your Supervisor/Manager at E1*
- Yes
- No
Employer 2 (E2)
E2 Name
E2 Address
E2 Phone
E2 Start Date
MM slash DD slash YYYY
E2 End Date
MM slash DD slash YYYY
Your Position at E2
Your Supervisor/Manager at E2
E2 Supervisor/Manager Phone
May we contact your Supervisor/Manager at E2*
- Yes
- No
Employer 3 (E3)
E3 Name
E3 Address
E3 Phone
E3 Start Date
MM slash DD slash YYYY
E3 End Date
MM slash DD slash YYYY
Your Position at E3
Your Supervisor/Manager at E3
E3 Supervisor/Manager Phone
May we contact your Supervisor/Manager at E3*
- Yes
- No

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References
References
Please list up to 3 references. Click the circled + symbol to add another row to the list.
Name Title Email Phone
Additional Skills
Additional Skills
List any additional skills that you would like to mention.
Resume
Please submit a copy of your resume in PDF format. Max file size 2MB.
Accepted file types: pdf, Max. file size: 2 MB.
Ready to Submit
Are you ready to submit the application?
- Yes
- No
Certify*
- By submitting this application I certify that all the information provided herein is correct and accurate.
Signature*

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