EMPLOYMENT APPLICATION

TO THE APPLICANT: This Employment Application form must be completed in full and signed before it will receive consideration for future employment with Ginsey Industries, Inc. Applications are retained in an active file for a total of 1 year. Should you wish to receive employment consideration after that period of time it will be necessary for you to complete a new application form. You may attach a resume to this completed form.

Ginsey Industries, Inc. is an equal employment opportunity employer, and as such, it is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classification.

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Application Information:

First Name *

Middle Initial

Last Name *

Phone Number *

Email Address *

Street *

City *

State *

Zip *

If hired by Ginsey, can you provide proof that you are eligible to work in the United States? *

Are your age 18 or older? *

Do you have a valid driver’s license? *

Have you ever applied to or worked for Ginsey Industries, Inc. before?

If "Yes", When?

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Employment-Related Information:

Position applying for *

Date you can start *

Are you able to work weekends and/or overtime, if required? *

Please note, we only have day shifts available. Please indicate if you are interested in daytime shift work. *

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Education and Training:

Select the highest level of Education completed

List any other education, training, special skills or certificates/licenses that you have acquired which are related to this job.

List any machines or equipment you are qualified to operate or experienced in operating.

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Former Employment:

(List your last three employers, starting with your present or most recent employer.)

Employer 1 (current):

Employer

Start Date

End Date

Address

City, State, Zip

Phone

Start Salary

End Salary

Job Title

Manager

Reason for Leaving

Work Performed

Employer 2:

Employer

Start Date

End Date

Address

City, State, Zip

Phone *

Start Salary

End Salary

Job Title

Manager

Reason for Leaving

Work Performed

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References:

Give names, addresses and telephone numbers of three references (not relatives or former employers.)

Reference 1:

Name

Address

Phone *

Reference 2:

Name

Address

Phone *

Submit your Resume and/or Cover letter *

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I acknowledge that the information I have provided is true to the best of my knowledge, and I authorize investigation of this information as may be necessary. Any misrepresentation or falsification of information, or significant omission, will be cause for rejection of my application, or for subsequent discipline up to and including termination of employment if discovered at a later date.

I understand that I will be required to submit to a pre-employment drug screening analysis. The results of such analysis may be grounds for disqualifying me or terminating my employment.

If employed, I understand that I will be an employee “at will” and that either Ginsey Industries, Inc. or I may terminate my employment relationship at any time, with or without cause, for any reason that does not violate the law.

Signature *

Date *

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

WE'RE HIRING!

EMPLOYMENT APPLICATION

Application Information:

Employment-Related Information:

Education and Training:

Former Employment:

Employer 1 (current):

Employer 2:

References:

Reference 1:

Reference 2:

Thanks for getting in touch!

Thanks for getting in touch!

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