Job Applications Step 1 of 7 14% Preferred Plant Location* Kermit 115 Personal InformationName* First Last Current Street Address Street Address City State / Province / Region ZIP / Postal Code Primary PhoneEmail* Preferred method of contactPhoneEmailBest time to contact youAnyMorningAfternoonEveningDo you have any physical limitations that might prevent you from fulfilling the essential requirements of the job with or without reasonable accommodations?*YesNoplease explainAre you able to work night shifts?*YesNoAre you able to lift 30-50 lbs?*YesNoAre you able to pull or push heavy doors?*YesNoDo you have a valid driver’s license?*YesNoplease explain Professional InformationI’m qualified to serve in the following position*Plant OperatorsTruck LoadersMechanicsMaintenance LeadLube/PMLab TechniciansWeldersElectriciansLogistic AnalystHatch OperatorsFront End Loader OperatorsDispatchersGeneral HelpersWarehouseNumber of years/months at current address? : Are you 18 years or older?*YesNoType of employment desiredFull TimePart TimeHave you ever been convicted of a crime?*NoYesplease explainDo you have any deferred prosecutions?*NoYesplease explainDo you have criminal charges pending?*NoYesplease explainHave you ever pled "Guilty" to, been convicted of, or pled "no contest to a felony?*NoYesplease explainHave you, within the last five years, pled "Guilty" to, been convicted of, had prosecution deferred in connection with, or pled "no contest" to a misdemeanor?*NoYesplease explainAre you legally eligible for employment in this country?YesNoDo you have any previous MSHA experience?*NoYesIf yes, how many years?*Please enter a number greater than or equal to 1.Is your training current?*YesNo Work HistoryAre you currently employed?* Yes No Current Employer* Phone*Fax Address* Position Held From* MM slash DD slash YYYY Position Held To* MM slash DD slash YYYY Job Duties performed* Reason for leaving* Salary/hourly rate* May we contact your current employer prior to hire?*YesNo Professional Information 1 (If any,you can add upto 3 previous companies)Have you previously been employed ?* Yes No Previous Employer* Phone*Fax Address* Position Held From* MM slash DD slash YYYY Position Held To* MM slash DD slash YYYY Job Duties performed* Reason for leaving*Salary/hourly rate* May we contact your current employer prior to hire?*YesNo Professional Information 2 (If any,you can add upto 3 previous companies)Have you previously been employed ?* Yes No Previous Employer* Phone*Fax Address* Position Held From* MM slash DD slash YYYY Position Held To* MM slash DD slash YYYY Job Duties performed* Reason for leaving*Salary/hourly rate* May we contact your current employer prior to hire?*YesNo Professional Information 3Have you previously been employed ?* Yes No Previous Employer* Phone*Fax Address* Position Held From* MM slash DD slash YYYY Position Held To* MM slash DD slash YYYY Job Duties performed* Reason for leaving*Salary/hourly rate* May we contact your current employer prior to hire?*YesNo If gap between employers, indicate reasonUnemployedAttending schoolSelf-employedOtherExplain ReasonPlease, briefly highlight your skills (140 characters )*Upload your Resume or cut and paste into the comment section aboveMax. file size: 256 MB.CAPTCHA Δ
