Complete Application Below

All fields marked by * must be filled out. Use N/A if necessary.

Location:

Position applying for:

*E-mail: Select resume to upload:


*Date (Eg.04/21/2013)

*First Name

*Last Name

Middle Name

Present Address

*No. and Street

*City

*State

*Zip

Permanent Address
(if different from present address)

No. and Street

City

State

Zip


Cell Phone

*Home Phone

*Last 4 digits of SSN


Referred by
 

How did you find out about us?
Craigslist
Linked In
Other(please specify):
 
 
 
Are you a US Veteran?
Yes No

Education, Training and Experience
High School

*Institution Name

*No. of years Completed
Yes No
*Did you Graduate?
 

*No. and Street

*City

*State

*Zip

College/University

Institution Name

No. of years Completed
Yes No
Did you Graduate?

Degree

No. and Street

City

State

Zip

Vocational/Business

Institution Name

No. of years Completed
Yes No
Did you Graduate?

Degree

No. and Street

City

State

Zip

Employment History

List below all present and past employment starting with your most recent employer (last five years is sufficient).
Account for all periods of unemployment. You must complete this section even if attaching a resume.


*Name of Employer

*Telephone No.

*Type of Business

*Supervisor's Name

*No. and Street

*City

*State

*Zip

*Dates of Employment From: (Eg.04/21/2013)

*To: (Eg.04/21/2013)

*Weekly Pay: starting

*Ending
*Your Position and Duties(500 chars max)

*Reason for Leaving
*May we contact this employer for a reference? Yes No


Name of Employer

Telephone No.

Type of Business

Supervisor's Name

No. and Street

City

State

Zip

Dates of Employment From: (Eg.04/21/2013)

To: (Eg.04/21/2013)

Weekly Pay: starting

ending
Your Position and Duties(500 chars max)

Reason for Leaving
May we contact this employer for a reference? Yes No

Note: Enter additional employment information if necessary.

References

List below three persons not related to you who have knowledge of your work performance within the last three years.


First Name

Last Name

Telephone No

No. and Street

City

State

Zip

Occupation

No. of Years Acquainted


First Name

Last Name

Telephone No

No. and Street

City

State

Zip

Occupation

No. of Years Acquainted


First Name

Last Name

Telephone No

No. and Street

City

State

Zip

Occupation

No. of Years Acquainted

Personal Information

*Have you ever applied to or worked for Industrial Metal Supply Company before?
Yes No

*If yes, when?

*Do you have any friends or relatives working for Industrial Metal Supply Company?
Yes No
*If yes, state name(s) and relationship:

Name

Relationship

Name

Relationship

*Why are you applying for work at Industrial Metal Supply Company?

*If hired, would you have a reliable means of transportation to and from work?
Yes No
*Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.)
Yes No
If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?
Yes No
If no, describe the functions that cannot be performed.

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

*Have you ever been convicted of a criminal offense (felony or misdemeanor)?
Yes No
*If yes, state nature of the crime(s), when and where convicted and disposition of the case.
Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.

Please Read Carefully, Initial Each Paragraph and Sign Below:


*Initials
 

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.


*Initials
 

I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release Industrial Metal Supply Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.


*Initials
 

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or Industrial Metal Supply Company, and that no promises or representations contrary to the foregoing are binding on Industrial Metal Supply Company unless made in writing and signed by me and the companys designated representative.


*Initials
 

Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by Industrial Metal Supply Company I am entitled to copies of any such public records obtained by Industrial Metal Supply Company unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.

 

I waive receipt of a copy of any public record described in the paragraph above

 


Date (Eg.04/21/2013)

Enter your name
(Your IP address will be collected as proof of signature)


*Date (Eg.04/21/2013)

*Enter your name
(Your IP address will be collected as proof of signature authorizing the Procurement of the Consumer Report and/or Investigative Consumer Report)

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