APPLICANT QUESTIONS:

* Type of Work Desired:

* Salary Desired: * Date Available:

* If hired, can you provide documents required to establish
your eligibility to work in the U.S?: Yes No

* Are you 16 years of age or older?: Yes No

How were you referred to our company?:

EDUCATION:

High School or last grade completed:

* Name and address of school:


* Course of Study:

* Number of Yrs completed:

* Degree / Diploma:


College or Technical School:

Name and address of school:


Course of Study:

Number of Yrs completed:

Degree / Diploma:


Other Schooling or Training:

Name and address of school:


Course of Study:

Number of Yrs completed:

Degree / Diploma:

MILITARY EXPERIENCE:

Branch of Service


From: To:

Rank / Type of Service:

Special Training / Experience:

RECORD OF EMPLOYMENT:

List positions starting with most recent:

* Employer1:

* Telephone:

* Address:


* Position / Title:

* Supervisor:

* Start Date: * Date Left:

* Beginning Salary: * Ending Salary:

* Duties:


* Reason for Leaving:

* Employer2:

* Telephone:

* Address:


* Position / Title:

* Supervisor:

* Start Date: * Date Left:

* Beginning Salary: * Ending Salary:

* Duties:


* Reason for Leaving:

* Employer3:

* Telephone:

* Address:


* Position / Title:

* Supervisor:

* Start Date: * Date Left:

* Beginning Salary: * Ending Salary:

* Duties:


* Reason for Leaving:

WORK-RELATED REFERENCES: (Do not include relatives)

1.) * Name:

* Occupation: * Years Known:

* Contact Info:

< 2.) * Name:

* Occupation: * Years Known:

* Contact Info:

3.) * Name:

* Occupation: * Years Known:

* Contact Info:

STATEMENT (Please read this statement carefully before signing this application):

I understand that employment with Precision Tool and Mold, Inc. (the Company) is at-will, meaning that I or the Company may terminate my employment at any time, or for any reason consistent with applicable state or federal law.

I authorize the Company to conduct a thorough background investigation of my work and personal history, and verify all data given on this application and during interviews. I hereby release the Company, and its representatives or agents, from any liabilitiy that might result from such an investigation. I authorize all individuals, schools, and firms named to provide any requested information and release them from all liability for providing the requested information.

I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for employment, I must submit a new application. I certify that all the statements in this completed application are true and understand that any falsification or willful omissions shalll be sufficient cause for dismissal or refusal to hire.

* Signature of Applicant:

* Date Signed:
(By typing my name here and submitting this application, I certify this represents my signature.)

Precision Tool & Mold
12050 44th St. N.
Clearwater, FL  33762

Phone # (727) 573-4441
Fax # (727) 573-0777

E-Mail

Copyright © 2010 Precision Tool and Mold. All rights reserved.
Revised: August 2010
Rondon Consulting