Application for Employment

An Equal Opportunity Employer

(EEO/MFDV)

08/03

NOTICE TO APPLICANTS:

Ton Anchor Mfg., Inc. does not discriminate on the basis of race, color, religion, gender, sexual orientation, national origin, age, disability, veteran status, or any other characteristic protected by law. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. Any individual, who, because of a disability, needs accommodation or assistance in completing this application or at any time during the application process, should contact Jodi Loehr, Operations Manager at jodi@tonanchor.com.

INSTRUCTIONS:

The purpose of the employment application form is to provide you with the opportunity to describe your experience, skills, abilities and other personal attributes, which would make you eligible to be considered for a sales position. Please complete the entire application. No action can be taken on this application until all questions are answered. Use blank paper if you do not have enough room on this application.

Today's Date:				Date you are available to begin working at Ton Anchor Mfg., Inc.:
Position(s) applying for:
Type of employment you are seeking:	Full-time Part-time
Last Name:		First Name:			Middle Initial:
Street Address:		Apartment #:
City/State:		Zip Code:			E-mail address:
Day telephone #:		Evening telephone #:			Social Security #:
Are you at least 18 years of age?			Yes No	If you are hired, you may be required to submit proof that you at least 18 years of age.
Are you legally authorized to work in the United States on a regular, continuing basis?			Yes No
Are you currently being considered for any other position at Ton Anchor Mfg., Inc.?			Yes No	If yes, provide approximate date and position.
Have you been employed by, or provided services to, Ton Anchor Mfg., Inc. in the past?			Yes No	If yes, provide approximate date, location, and function.
If employed by Ton Anchor, do you expect to be engaged in any other business or employment?			Yes No	If yes, provide details.
Have you had a criminal conviction in the past seven (7) years?			Yes No	If yes, provide details:
(A “yes” response does not automatically disqualify you from employment, but will be considered as part of an overall evaluation of your qualifications.)
FOR DRIVING JOBS ONLY: § Do you have a valid driver's license?			Yes No	Please indicate Class (Type) of License?
§ Have you had your driver's license suspended or revoked in the past three (3) years?			Yes No	If yes, provide details?

Employment Record
Work Experience Not Necessary to complete if your also attaching a current resume. List current or most recent employer first.
Employer:		Type of business (e.g. manufacturing, consulting, etc.):
Employer address (City, State):		Title of Position:	Employer Phone #:
Start date (MM/DD/YY):	Leave date (MM/DD/YY):	Beginning Salary:	Ending Salary:
Name and Title of Supervisor:		May we contact? Yes No
Description of position responsibilities:
Reason for leaving:
Employer:		Type of business (e.g. manufacturing, consulting, etc.):
Employer address (City, State):		Title of Position:	Employer Phone #:
Start date (MM/DD/YY):	Leave date (MM/DD/YY):	Beginning Salary:	Ending Salary:
Name and Title of Supervisor:		May we contact? Yes No
Description of position responsibilities:
Reason for leaving:
Employer:		Type of business (e.g. manufacturing, consulting, etc.):
Employer address (City, State):		Title of Position:	Employer Phone #:
Start date (MM/DD/YY):	Leave date (MM/DD/YY):	Beginning Salary:	Ending Salary:
Name and Title of Supervisor:		May we contact? Yes No
Description of position responsibilities:
Reason for leaving:

Education and Training LIST ALL DEGREES THAT YOU HAVE EARNED AND TRAINING COMPLETED. HIGHEST LEVEL OF COMPLETED EDUCATION WILL BE VERIFIED.
Type of School	Name and location of school (City, State)			Type of Degree Earned	Major and Minor Fields of Study
High School
Business or Trade School
Junior College
College or University
Graduate School
Post Graduate
Training Completed
Other or additional Training/Certification (please explain):
If you are currently working towards a degree or completing your training, please explain:
What is your military service history (including Branch, rank, duties, schools and training)?
List professional, trade, business or civic activities and offices held. (Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, disability or other protected status.)
Have you worked or attended school under any other name?		Yes No	If yes, please provide names:
Are you currently employed?		Yes No	If yes, may we contact your current employer?			Yes No
Have you ever been fired from a job or asked to resign?		Yes No	If yes, please explain:

Please list three (3) references (do not provide names of relatives):
Name	Address	Phone #

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING
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