Wire Belt Company
 
Application for Employment
(PRE-EMPLOYMENT QUESTIONAIRE) (AN EQUAL OPPORTUNITY EMPLOYER)

 

PERSONAL INFORMATION
First Name:
Last Name:
Email Address:
Phone Number:
Street Address:
State:
Zip Code:
   
Are you 18 ot older?
Yes
No
 
Are you prevented from lawfully becoming employed in this country because of VISA or immigration status?
Yes
No
 
EMPLOYMENT DESIRED
Position:
Date you can start:
Salary desired:
 
Are you employed now?
Yes
No
 
If you are may we inquire of your present Employer?
Yes
No
 
Ever applied to this company before?
Yes
No
 
If "Yes" where did you apply?
If "Yes" when did you apply?
 
Were you Referred by anyone?
Yes
No
 
If "Yes" who referred you?
   
EDUCATION
GRAMMAR SCHOOL  
Name of the School:
Location of school:
Number of years attended:
 
Did you graduate?
Yes
No
 
   
HIGH SCHOOL  
Name and location of the School:
Location of school:
Number of years attended:
 
Did you graduate?
Yes
No
 
 
COLLEGE  
Name of the College:
Location of College:
Number of years attended:
 
Did you graduate?
Yes
No
 
Subjects studied:
 
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL  
Name of the School:
Location of the School:
Number of years attended:
 
Did you graduate?
Yes
No
 
Subjects studied:
   
GENERAL
Subjects of special study or research work:
Special skills:
Activities: (Civic, Athletic, Etc.)
U.S. Military or Naval service:
Rank:
 
Present membership in National Guard or Reserves:
Yes
No

TERMS:

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company’s option. I also understand and agree that the terms and considerations of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it’s president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing.

I UNDERSTAND AND AGREE (by checking this box you understand and agree to the terms above. TO BE CONSIDERED FOR EMPLOYMENT YOU MUST CHECK THIS BOX {REQUIRED} )
   
 
 


Wire Belt Company of America • 154 Harvey Road, Londonderry, NH 03053 • Tel: 603-644-2500 • Fax: 603-644-3600
Site Map • Terms & Conditions • © 2006 Wire Belt Company of America • An ISO 9001:2000 Registered Company