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Fab-Lite, Application for Employment
We are an Equal Opportunity Employer
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Indicates required field
Name
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First
Last
Middle Name
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Any other name you have used in connection with employment, education, U.S. military service, or any criminal conviction or pending felony charge.
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Present Address
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Line 1
Line 2
City
State
Zip Code
Country
Permanent Address
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Line 1
Line 2
City
State
Zip Code
Country
Are you 18 years or older?
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Yes
No
Do you have reliable transportation?
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Yes
No
If not, please explain:
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Phone Number
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Email
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If you have an email, please list.
Describe any U.S. Military Service (Branch, Rank, Nature and Date of Discharge)
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Are you presently in the National Guard or Reserve? (If so, identify unit and any service obligations)
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Have you ever been convicted of a crime or are you presently charged with a felony? If so, where and when, and explain circumstances:
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EMPLOYMENT DESIRED (position)
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Date you can start
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month/day/year
Salary Desired
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Are you employed now?
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Yes
No
If so, may we contact your current employer?
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Yes
No
Not Currently Employed
Relatives or Aquaintences employed here?
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Yes
No
Have you ever worked here before?
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Yes
No
If so, what position(s) and when?
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If so, list thier FULL name and relationship to you:
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Do you have any activities, commitments or responsibilities (school, other employment, etc.) which might, in any way interfere with your ability to work full time, including overtime, in the position for which you are applying?
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Yes
No
If so, please list:
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PROFESSIONAL REFERENCES
(give the names of three persons not related to you)
Name
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First
Last
Business
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Years Acquainted
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Phone Number
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Name
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First
Last
Business
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Years Acquainted
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Phone Number
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Name
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First
Last
Business
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Years Acquainted
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Phone Number
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FORMER EMPLOYMENT
List below ALL employment history up to last four employers, starting with the last one first:
1st
Date - Month & Year
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Name & Address of Employer
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Reason for Leaving
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Salary/Hourly
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Position/Job Duties
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2nd
Date - Month & Year
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Name & Address of Employer
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Reason for Leaving
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Salary/Hourly
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Position/Job Duties
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3rd
Date - Month & Year
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Name & Address of Employer
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Reason for Leaving
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Salary/Hourly
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Position/Job Duties
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4th
Date - Month & Year
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Name & Address of Employer
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Reason for Leaving
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Salary/Hourly
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Position/Job Duties
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Describe fully the nature of the work in your present (or most recent) job:
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What special skills or knowledge do you have which will aid in qualifying for employment (include tools and machines)?
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Which of your jobs did you like best and why?
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EDUCATION
Grammar School
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Name and Location
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Subjects Studied
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# of years attended
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Did you graduate?
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Yes
No
High School
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Name and Location
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Subjects Studied
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# of years attended
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Did you graduate?
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Yes
No
College, Trade or Corr. School
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Name and Location
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Subjects Studied
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# of years attended
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Did you graduate?
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Yes
No
General subjects of special study or research work:
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READ CAREFULLY AND SIGN BELOW IF YOU AGREE TO THESE TERMS OF EMPLOYMENT:
1. I understand and agree that if I become an employee my employment will be at will and may be terminated by me or the Employer at any time for any cause or no cause. I understand and agree that no officer, agent or employee of the Employer has any authority to limit in any way the Employer’s right to terminate employment at will, or to offer employment other than on an at-will basis. I also understand and agree to the Employer's policy that the Employer's decisions on all employment related matters are final, and are not subject to review or appeal outside the Employer except as required by laws providing or requiring employers to provide specific employment standards and rights.
2. I agree that except as prohibited by statute the Employer may, during or after my employment, disclose or discuss any information or opinions relating to me or my employment to employees of the Employer or third parties. I waive written or other notice of any such disclosure (including disclosure of disciplinary matters), and I release and promise not to make any claims against the Employer (or its employees, directors, owners or agents) relating to any such disclosure or discussion.
3. I agree that except at the request and for the benefit of the Employer, I will not disclose to anyone or use for my own purposes any non-public information about the Employer, its practice, patients, and employees. I agree that if my employment with the Employer ends, I will deliver to the Employer all material of any kind that I have relating to the Employer, including any such copies or notes.
4. I agree that any claim or lawsuit relating to my application for employment or my employment with the Employer, or relating to the termination of such employment, must be filed with the appropriate government agency or court within 6 months after the act or omission that is the subject of the claim or lawsuit, and I waive any statute of limitations to the contrary. I understand that this means that even if the law would normally give me the right to wait a longer time to file a claim or lawsuit, I am waiving that right, and that any
claim or lawsuit not filed within the above 6 months period will be barred.
5. I represent that in considering employment with I am not relying and will not rely on statements or information other than as set forth in this application, and I waive and release any claims against the Employer (and its affiliated entities, and their officers, directors, owners, employees and agents), arising out of or related to any such statements or information, or relating to any failure by the Employer to disclose any information.
6. I agree to the above terms of employment. I understand and agree that, except as provided above, all benefits, programs, rules and policies of the Employer are subject to exceptions or change at will at any time as decided by the Employer.
Date
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Signature of Applicant
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SUPPLEMENT - AUTHORIZATION AND WAIVER
I authorize Fab-Lite to request any information and opinions about me from my former employers, references, educational institutions, and any credit agencies or reporting services which have information about me in their possession and which may lawfully be disclosed. I hereby waive written notice of such release of information and opinions, and I release such former employers, references, educational institutions, and credit agencies or reporting services from any liability or claim relating to such release of information and opinions. I also authorize and request federal, state, and local governmental agencies to release to Metalworks any information requested concerning any criminal convictions on my record. A photocopy of this signed authorization and waiver shall be valid as an original.
Date
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Signature of Applicant
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Submit Application
