Guttenberg Industries Job Application
Job Application
Name
Last Name: *
Your answer
First Name: *
Your answer
Middle Name: *
Your answer
Present Address
Where you are currently living
Present Address Street *
Your answer
Present Address City *
Your answer
Present Address State *
Your answer
Present Address Zip Code *
Your answer
Permanent Address
Your home of record
Permanent Address Street *
Your answer
Permanent Address City *
Your answer
Permanent Address State *
Your answer
Permanent Address Zip Code *
Your answer
Email
Your answer
Phone number *
Your answer
Are you 18 years or older? *
Are you a U.S. Citizen or an alien authorized to work in the United States? *
Employment Desired
Desired Position: *
Your answer
Date you can start *
Your answer
Salary Desired
Your answer
Referred By
Your answer
What is your shift preference? *
Are you employed now? *
Have you ever worked for Guttenberg Industries, Inc. before? *
Have you ever applied to our company before? *
If Yes, When?
Your answer
Education
Grammar School
Name and Location of Grammar School *
Your answer
No. of years attended *
Your answer
Did you graduate? *
Subjects Studied
Your answer
Education
High School
Name and Location of High School *
Your answer
No. of years attended *
Your answer
Did you graduate? *
Education
College
Name and Location of College *
Your answer
No. of years attended
Your answer
Did you graduate?
Subjects Studied
Your answer
Education
Trade, Business, or Correspondence School
Name and Location of Trade, Business, or Correspondence School
Your answer
No. of years attended
Your answer
Did you graduate?
Subjects Studied
Your answer
General Information
Exclude any information or organizations, the name of which, indicates the race, creed, sex, age, marital status, color or nation of origin of its members
Subjects of Special Study or Research Work
Your answer
Special Skills
Your answer
Activities: (Civic, Athletic, Etc.)
Your answer
U.S. Military or Naval Service (include rank or pay grade)
Your answer
Current or Most Recent Employer
Name and Address of Current or Most Recent Employer *
Your answer
Dates of Employment (From - To) *
Your answer
Position Duties *
Your answer
Salary
Your answer
Reason for Leaving *
Your answer
Next Previous Employer
Name and Address of Previous Employer *
Your answer
Dates of Employment (From - To) *
Your answer
Position Duties *
Your answer
Salary
Your answer
Reason for Leaving *
Your answer
Next Previous Employer
Name and Address of Previous Employer
Your answer
Dates of Employment (From - To)
Your answer
Position and Duties
Your answer
Salary
Your answer
Reason for Leaving
Your answer
Next Previous Employer
Name and Address of Previous Employer
Your answer
Dates of Employment (From - To)
Your answer
Position and Duties
Your answer
Salary
Your answer
Reason for Leaving
Your answer
References
Give the names of three persons not related to you, whom you have known at least one year.
Name of 1st Reference *
Your answer
Address & Phone Number *
Your answer
Business
Your answer
Years Acquainted *
Your answer
Name of 2nd Reference *
Your answer
Address & Phone Number *
Your answer
Business
Your answer
Years Acquainted *
Your answer
Name of 3rd Reference *
Your answer
Address & Phone Number *
Your answer
Business
Your answer
Years Acquainted *
Your answer
Do you have any impairments, physical or mental, which would interfere with your ability to perform the job for which you have applied? *
Have you ever been convicted of a felony? *
If "Yes" please explain
Your answer
In Case of Emergency Notify
Name (In Case of Emergency Notify) *
Your answer
Phone Number *
Your answer
Address *
Your answer
*I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
* I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same to you.
* 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 at any time without prior notice and without cause.
* NOTE: All employment offers will be contingent upon satisfactory completion of a pre-employment drug screening.
IMPORTANT: Guttenberg Industries requires that you certify your application by submitting an electronic signature. To certify your application, type your full name below and click the Confirm Signature & Submit Application button.
Date *
Your answer
Name (electronic signature) *
Your answer
NOTE: *The Age Discrimination in Employment Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age. This form has been designed to strictly comply with State and Federal fair employment practice laws prohibiting employment discrimination.
Thank you for your interest in a career with Guttenberg Industries.
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