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EMPLOYMENT APPLICATION

    What position are you interested in?
    First name
    Middle name
    Last name
    Email
    Phone
    Date available
    Street address
    City
    State
    Zip code
    Desired hourly pay
    Are you at least 18 years old?
    Are you authorized to work in the U.S.?
    Are reasonable accommodations required for you to perfom the essential functions of the job you seek?
    What reasonable accommodations, if any, would you request?
    EDUCATION
    High school attended
    Did you graduate?
    Trade school attended
    List earned certification(s) or degree
    College attended
    List degree earned
    List any other certifications
    MILITARY SERVICE
    Did you serve in the military?
    If yes, what branch?
    Were you honorably discharged?
    List any special training
    List any honors, awards, or special achievements
    SKILLS

    List any skills that may be useful for the job you are seeking. Enter the number of years of experience and click the number which corresponds to your ability level for each particular skill. (One represents modest ability, while five represents exceptional ability.)

    Skill
    Years of experience
    Ability rating
    Skill
    Years of experience
    Ability rating
    Skill
    Years of experience
    Ability rating
    EMPLOYMENT HISTORY

    Please list all jobs beginning with your current or the most recent and list and explain any gaps in employment.

    Company name
    Dates of employment start date
    Dates of employment end date
    Company address, city, state and Zip
    Company phone
    Supervisor
    May we contact for a reference?
    Responsibilities
    Starting title
    Ending title
    Reason for leaving
    Company name
    Dates of employment start date
    Dates of employment end date
    Company address, city, state and Zip
    Company phone
    Supervisor
    May we contact for a reference?
    Responsibilities
    Starting title
    Ending title
    Reason for leaving
    Company name
    Dates of employment start date
    Dates of employment end date
    Company address, city, state and Zip
    Company phone
    Supervisor
    May we contact for a reference?
    Responsibilities
    Starting title
    Ending title
    Reason for leaving
    Company name
    Dates of employment start date
    Dates of employment end date
    Company address, city, state and Zip
    Company phone
    Supervisor
    May we contact for a reference?
    Responsibilities
    Starting title
    Ending title
    Reason for leaving
    ADDITIONAL INFORMATION
    Please explain any gaps in employment or any share other information that you think would be important for us to know about you and your experience.
    CERTIFICATION

    I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application or if employment commences, immediate termination.

    I authorize Abbottstown Industries Inc. to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment attendance and grades.

    If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Vice President, the employment relationship will be “at-will”. The relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause.

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