Pre-employment Questionnaire     An Equal Opportunity Employer

*required field

Date

Personal Information

Name:

*Last  *First    M.I.              

Home Message Cell Home Message Cell

Are you 18 years or older?   Yes No

Are you legally eligible to work in the United States?   Yes No

*What position are you applying for?
    Do not put "OPEN", or "ANY", or leave it blank - application will not be accepted

Date you can start:

Salary Desired:

Are you employed now?  Yes   No

If yes, may we inquire of your present employer? Yes No

Have you previously applied for employment with Master Metal Engineering?   Yes No

If yes, when?

How were you referred to Master Metal Engineering
Newspaper Employee    Temp Service Other

If referred by an employee or temp service, please provide name

High School      Years attended

Graduate? Yes No    Subjects Studied

College               Years attended    

Graduate? Yes No Subjects Studied

Technical School      Years attended    

Graduate? Yes No Subjects Studied

Any additional training? Yes No

If yes, please describe

Specialized skills

U.S. Military Service? Yes No

If yes, highest rank achieved

Former Employment
(List last four employers, starting with last one first)

Current or Most Recent Employer

Date from to

Position      Salary

Name and Location  

Reason for leaving   

Prior Employer 1

Date from to

Position      Salary

Name and Location              

Reason for leaving   

Prior Employer 2

Date from to

Position        Salary

Name and Location             

Reason for leaving   

Prior Employer 3

Date from to

Position      Salary

Name and Location              

Reason for leaving   

Which of the above jobs did you like best and why?

Which of the above jobs did you like least and why?

We currently have three shifts = which shift(s) are you available to work? Hours listed may vary due to production needs.
Day Shift (Monday-Thursday, 6:00am - 4:30pm)   Yes  No
Night Shift (Monday-Wed, 4:30pm-5:00am; Thurs 4:30pm - 8:30pm)   Yes No
Weekend Shift (Friday-Sunday, 4:00am - 4:30pm, paid for 40 hours)   Yes No

References

Name    Phone

Business      Years acquainted

Name    Phone

Business      Years acquainted

Name    Phone

Business      Years acquainted

In the last 10 years have you been convicted of a felony or other crime? Yes No

If Yes, please give details

I hereby authorize Master Metal Engineering to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability Master Metal Engineering and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations fro providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employemnt if I am employed, whenever it may be discovered. If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

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. I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

*By initialing this box you agree to the above terms and conditions