Precision Machined Components and Assemblies
Call Us : 1-608-297-9000

Application for Employment

Pre-Employment Questionnaire
An Equal Opportunity Employer

Your Name (required)

Present Address

Present City

Present State

Present Zip Code

Permanent Address

Permanent City

Permanent State

Permanent Zip Code

Phone

Email Address

Are you 18 years or 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 so may we inquire of your present employer?
 Yes No

Ever applied to this company before?
 Yes No

Where?

When?

Former Employers (List below last three employers, starting with the last one first).

#1

Date (Month and Year)

From

To

Name and Address of Employer

Salary

Position

Reason for leaving

#2

Date (Month and Year)

From

To

Name and Address of Employer

Salary

Position

Reason for leaving

#3

Date (Month and Year)

From

To

Name and Address of Employer

Salary

Position

Reason for leaving

Which of these jobs did you like best?

What did you like most about this job?

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