Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. If you do not have enough room on any part of the application, there will be a section at the end for entering additional information. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information. *
Today's Date
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MM
DD
YYYY
When Could You Start Work?
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Type of Employment
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Name
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First Name
Last Name
Phone Number
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(###)
###
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Current Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Are You 18 Years of Age or Older?
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If hired, you may be required to provide proof of age.
If hired, can you furnish proof you are eligible to work in the U.S.?
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Have you ever applied to PMC before?
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If yes, when?
Have you ever been employed by PMC before?
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If yes, when?
Have you ever been convicted of any law violations?
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Include plea of "guilty" or "no contest." Exclude minor traffic violations.
If yes, please give details:
(A conviction will not necessarily disqualify an applicant for employment.)
If employed, do you expect to be engaged in any additional business or employment outside of our job?
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If yes, please give details:
Do you have a valid driver’s license?
For Driving Jobs Only
Have you had your driver's license suspended or revoked in the last 3 years?
For Driving Jobs Only
If yes, please give details:
List professional, trade, business or civic activities and offices held.
(Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability or other protected status.)
Name and Address of High School or GED Program Attended:
Number of Years Attended
Subjects Studied
Name and Address of College or University Attended:
Number of Years Attended
Subjects Studied
Name and Address of any Vocational or Technical School Attended:
Number of Years Attended
Subjects Studied
What skills or additional training do you have that relate to the job for which you are applying?
What machines or equipment can you operate that relate to the job for which you are applying?
List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. if self-employed, give firm name and supply business references. Note: A job offer may be contingent upon acceptable references from current and former employers.
Employer Address
Reason for Leaving
Employer Address
Reason for Leaving
Employer Address
Reason for Leaving
Employer Address
Reason for Leaving
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If yes, please give names:
Are you presently employed?
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If yes, whom do you suggest we contact?
Have you ever been fired or asked to resign?
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If yes, please explain:
If you ran out of room on any section of this application or need to enter in any additional information that is relevant
I have read, understand, and by my signature consent to these statements.
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Type your full legal name below to sign your application.
Date
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MM
DD
YYYY
