On-Line Employment
Application Form
 
The following information is confidential to StrucSteel and will not be shared with any other parties
First Name
Last Name
Middle Intl.
E-mail Address

 
Present Address    
Street#:
 
City: State: Zip
     
Permanent Address (if different)  
Street#:
 
City: State: Zip
     
Home Phone

Message Phone
Social Security (optional)
 
If you are hired, can you furnish proof you are 18 or older? yes no
   
If you are hired, can you present evidence of your legal right to live and work in this country as required by law? yes no
     
Have you ever pled guilty or "no contest" to, or been convicted of, a misdemeanor or felony? yes no  
If yes give dates & details:
     
Have you ever been arrested for any matters for which you are out on bail or on your own recognizance pending trial? yes no
If yes give dates & details:
Answering "Yes" to these questions does not constitute an automatic bar to employment. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account. (Do not include minor traffic infractions, and convictions for which the record has been sealed or expunged, any conviction for which probation has been successfully completed or otherwise discharged and the case has been judicially dismissed, referrals to and participation in any pretrial or posttrial diversion programs, and marijuana-related offenses that occured over two years ago in answering these questions.
     
Are you able to satisfactorily perform the essential job duties required of the position for which you are applying, either with or without an accomodation? yes no  
 
Position Desired Date you can start
 
Which do you prefer? Full Time Part Time during following days & hours:
 
Are you employed now? yes no
(If so may we contact your present employer? yes no)
 
Have you ever applied or worked for this company before? yes no
  If yes, specify dates
 
Education Name of School City & State #Yrs Completed Graduated? Degrees
Highschool
College
Graduate
Have you ever served in the United States Armed Forces? yes no
Branch Final Rank
           
Additional training, skills, experience, and special achievements relative to position:
 
Employment History beginning with most recent:
Month/
Year
Name & Address of Employer
Initial Position & Duties
Previous Supervisor
Starting Pay
Reason for Leaving
Final Position & Duties
Telephone #
Ending Pay
From



To




MM
YY

MM
YY
 
Month/
Year
Name & Address of Employer
Initial Position & Duties
Previous Supervisor
Starting Pay
Reason for Leaving
Final Position & Duties
Telephone #
Ending Pay
From



To




MM
YY

MM
YY
 
Month/
Year
Name & Address of Employer
Initial Position & Duties
Previous Supervisor
Starting Pay
Reason for Leaving
Final Position & Duties
Telephone #
Ending Pay
From



To




MM
YY

MM
YY
Have you ever been terminated or asked to resign from a job? yes no
 
If yes, explain
     
Please explain fully any gaps in your employment history:  
How many days of work have you missed in the last three years due to reasons other than paid holidays & vacation?  
Year
#Days
Year
#Days
Year
#Days
           
Do you have adequate transportation to & from work? yes no
     
Do you have any friends or relatives that work for the company? yes no
  If yes, who?
     
Is any additional information relative to change of name, use of an assumed name, or nickname necessary to enable a check on your work and educational record?
yes no
If yes, explain?
 
If references are requested are you able to supply them?
yes no
 
This application will be considered active for a maximum of thirty (30) days. If you wish to be considered for employment after that time, you must reapply.
     
I certify that all the information that I have provided on this application is true and accurate
Type your name and date: name date
     
Please check entire form carefully before submitting