Infinity Machines & Engineering

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THIS COMPANY IS AN EQUAL OPPORTUNITY EMPLOYER

PLEASE ANSWER ALL QUESTIONS COMPLETELY AND ACCURATELY
   
Name:  
  (Last) (First) (Middle)  
         
Address:
  (Number & St) (City) (State) (Zip Code)
   
If your  CURRENT address is Outside of the United States please enter it here:
  Was an APO location Yes No


 
Telephone: Cell Phone:  
   
Previous Address:
  (Number & St) (City) (State) (Zip Code)
   
If your PREVIOUS address was Outside of the United States please enter it here:
  Was an APO location Yes No

 
Wage/Salary Desired: $ /Hr
 
Hours Desired:   Full Time    Part Time   Temporary
 
Identify relevent skills or training you have or equipment you can operate:
 
Have you been employed or applied for employment with this company before? Yes No
 
Are you over age 18?   Yes No
Are you over age 16?   Yes No
   
What position are you applying for? 
   
Were you referred here? How? 
   
List names of any friends or relatives who work for the Company:
Name: Relationship: 
Name: Relationship: 
   
Personal References  
Name Address Telephone:
1.

Occupation / Relationship to you /  
     
2.

Occupation / Relationship to you /  
     
3.
Occupation / Relationship to you /  
     
 
Education
  Institution Name Address Years Complete Degree
High School: 9  10 11  12
College: 1 2   3   4
Graduate Work: 1 2   3   4
Other: 1 2   3   4
 
Only US Citizens or aliens who have a legal right to work in the US are eligible for employment. Can you, upon employment, submit documentation of your identity and your legal right to work in the US?   Yes No
 
Employment History: List all Position held starting with the most recent. Use Additional Boxes if needed
 
Employer 1
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
Employer 2
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
Employer 3
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
Employer 4
 
  (Name) (Address) (Telephone)
 
  (Duties) (Title) (Supervisor)
  to  per 
  (Dates of Employment) (Salary)
 
  (Reason for Leaving)
 

Have you ever been a defendant in a civil action for and intentional tort?   Yes No

If YES, please state the circumstances, including a description of the nature of the intentional tort, the date that it was  allegedly committed and the disposition of the action.

Have you ever been convicted of a crime, had adjudication withheld, or pled no contest to a crime?   Yes No

If YES, please state the type of crime and the circumstances with regard to each, including date of the conviction or pleas and the penalty, if any, imposed by the court.

NOTE: Answering YES to any of these questions may not necessarily disqualify you from the position you desire. Each action and explanation will be weighted/considered in relationship to the position for which you are applying.
 

Confirmation Area

 

I attest to the truthfulness of any and all information and answers provided above. Any false or misleading statements will be grounds for denial of employment or discharge. I understand the company will be checking into my references and employment background. I authorize the Company to do so and release from liability anyone giving or obtaining such background information. This application does not constitute a contract of employment or an indication that any jobs are available. Any employment with the Company is at­will, meaning the employer or employee can end the employment relationship at any time for any or no reason and with or without notice. My signature below verifies that I have read and understand the foregoing statements.

I Agree to the Terms and Conditions Above.

 
 
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Today's Date 09/09/2010

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