Current Position Available

Production Worker - Maley & Wertz, Evansville, IN

Personal Information

Name*

Email Address*

Mobile Phone*

Address*

City*

State*

Zip Code*

Are you at least 18 years or older?*

Yes

No

Are you a U.S. Citizen? (or have a visa permitting employment)*

Yes

No

Have you been convicted of or pleaded no contest to a felony within the last five years?*

Yes

No

If you answered yes, please describe and indicate dates:

How did you hear about us?

Have you previously been employed with our company?

Yes

No

Current Maley & Wertz Employee References

Current Compensation

Per Hour

Per Year

Desired Compensation

Per Hour

Per Year

Education

School 1 - Name

School 1 - Type

High School

College or University

Post Graduate Work

Other Schooling

School 1 - Status

Completed / Graduated

Incomplete / Qualification not earned

Currently attending

School 1 - Start Date

School 1 - End date

School 1 - Skills, qualifications, licenses, training, awards

School 2 - School Name

School 2 - Type

High School

College or University

Post Graduate Work

Other Schooling

School 2 - Status

Completed / Graduated

Incomplete / Qualification not earned

Currently attending

School 2 - Start Date

School 2 - End date

School 2 - Skills, qualifications, licenses, training, awards

Employment

Current or Last Employer

This is my current employer

Job Title

Employment Start Date

Employment End date

Reason for Leaving

Job Duties

Immediate Supervisor

Phone

May we contact this employer?

Yes

No

Previous Employer

Job Title

Employment Start Date

Employment End date

Reason for Leaving

Job Duties

Immediate Supervisor

Phone

May we contact this employer?

Yes

No

Please explain any gaps in your employment history:

Have you ever been a member of the United States Military Service?

Yes

No

What Branch (If applicable)

Rank at Discharge (If applicable)

Type of Discharge (If applicable)

Start Date of Service (If applicable)

Date of Discharge (If applicable)

Special skills, training, or experience acquired in the military (If applicable)

References

Reference 1 - Name

Reference 1 - Email Address

Reference 1 - Phone

Reference 1 - Employer Name

Reference 1 - Employer Title

Reference 1 - Relationship to applicant (If applicable)

Reference 2 - Name

Reference 2 - Email Address

Reference 2 - Phone

Reference 2 - Employer Name

Reference 2 - Employer Title

Reference 2 - Relationship to applicant (If applicable)

Reference 3 - Name

Reference 3 - Email Address

Reference 3 - Phone

Reference 3 - Employer Name

Reference 3 - Employer Title

Reference 3 - Relationship to applicant (If applicable)

Certification*

I certify that my answers to all questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application or during the pre-employment process may be grounds for my immediate termination.

I have read and agree to this statement

Comments

Opt in to text messages*

Would you like to receive text messages from Maley & Wertz regarding your status in the hiring process? Data rates may apply.

Yes

No

Privacy Policy Acknowledgement*

By checking this box, you acknowledge and consent to terms of the privacy policy which applies to the applicant tracking service being initiated on behalf of Maley & Wertz. The privacy policy offers an explanation of how and why your data will be collected, how it will be used and disclosed, how it will be retained and secured, and what legal rights are associated with that data (including the rights of access, correction, and deletion). The policy also describes legal and contractual limitations on these rights. The specific rights and obligations of individuals living and working in different areas may vary by jurisdiction.