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American Cap Company | ACCI Industries | PTR Tool & Plastics | Premier Hydraulics
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Home
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Employment Application
Home
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Employment Application
Employment Application
"
*
" indicates required fields
Position Applied For:
*
Applicant Information
Name:
*
First
Middle
Last
Address:
*
Street Address
Address Line 2
City
State
Zip
Phone:
*
Email:
*
Date Available:
*
MM slash DD slash YYYY
Desired Salary:
*
Best means of communication:
*
Email
Text
Phone Call
Are you authorized to work in the U.S.?
*
Yes
No
Have you ever worked for this company?
*
Yes
No
If yes, when?
MM slash DD slash YYYY
Education
High School:
*
High School Address:
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Did you graduate from High School?
Yes
No
College:
College Address:
Street Address
City
State / Province / Region
ZIP / Postal Code
Did you graduate from College?
Yes
No
Subjects Studied / Degrees Received:
Other Education:
Other Address:
Street Address
City
State / Province / Region
ZIP / Postal Code
Did you graduate from Other?
Yes
No
Subjects Studied / Degrees Received:
General Job Related Skills:
(What machines can you operate?)
References
Please list three professional references.
Full Name #1:
*
Years Known #1:
*
Address #1:
*
Phone #1:
*
Full Name #2:
*
Years Known #2:
*
Address #2:
*
Phone #2:
*
Full Name #3:
Years Known #3:
Address #3:
Phone #3:
Previous Employment
Company #1:
*
Phone #1:
*
Address #1:
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Job Title #1:
*
Responsibilities #1:
*
From Date #1:
*
MM slash DD slash YYYY
To Date #1:
*
MM slash DD slash YYYY
Still Working? #1
Yes
Reason for Leaving #1:
*
Company #2:
Phone #2:
Address #2:
Street Address
City
State / Province / Region
ZIP / Postal Code
Job Title #2:
Responsibilities #2:
From Date #2:
MM slash DD slash YYYY
To Date #2:
MM slash DD slash YYYY
Still Working? #2
Yes
Reason for Leaving #2:
Company #3:
Phone #3:
Address #3:
Street Address
City
State / Province / Region
ZIP / Postal Code
Job Title #3:
Responsibilities #3:
From Date #3:
MM slash DD slash YYYY
To Date #3:
MM slash DD slash YYYY
Still Working? #3
Yes
Reason for Leaving #3:
Company #4:
Phone #4:
Address #4:
Street Address
City
State / Province / Region
ZIP / Postal Code
Job Title #4:
Responsibilities #4:
From Date #4:
MM slash DD slash YYYY
To Date #4:
MM slash DD slash YYYY
Still Working? #4
Yes
Reason for Leaving #4:
Upload Resume (Optional)
Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 256 MB.
Disclaimer and Signature
Consent
*
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in loss of employment.
If you are hired by American Cap Company you will be required to present documents confirming your identity and employment eligibility. You cannot be hired if you cannot comply with this requirement. The Immigration Reform & Control Act of 1986 prohibits employers from hiring aliens not legally eligible to work in the United States and requires all newly hired employees to present and verify evidence of employment eligibility.
AUTHORIZATION
I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by American Cap. I understand that any employment is conditioned on a background check. I authorize American Cap Co. to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to American Cap Co., without giving me prior notice of such disclosure. In addition, I release American Cap Co., any former employers and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure. I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without cause and without prior notice of either myself or American Cap Co. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon American Cap Co., unless it is made in writing. If I am offered employment I agree to submit to a medical examination and drug test before starting work. If employed, I also agree to submit to a medical examination and drug test at any time deemed appropriate to American Cap Co. and as permitted by law. I consent to any such examinations and tests, and I request that the examining doctor disclose to American Cap Co. the results of the examination or test, which results shall remain confidential and separated from my personnel file. I understand that my employment or continued employment, to the extent permitted by law is contingent upon satisfactory medical examinations and drug tests, and if I am hired a condition of my employment will be that I abide by American Cap's Drug and Alcohol Policy. I understand that filling out this form does not indicate there is a position open and does not obligate American Cap Co. to hire. If hired, I agree to abide by all American Cap's work rules, policies and procedures. American Cap retains the right to revise its policies or procedures in whole or in part, at any time.
Signature:
*
(Input full name as signature)
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