Waukesha: 262-446-0655 Brookfield: 262-230-1020 Hartland: 262-367-8000 Cedarburg: 262-375-1060 Mander Glass: 262-369-9000

Waukesha

Brookfield

Hartland

Cedarburg

Mander Mobile Glass

Schedule

EMPLOYMENT APPLICATION

Haga click aqui para llenar un formato de empleo en español

First Name

Middle.I

Last Name

Todays Date

Address

City

State

Zip Code

Home Phone

Alternate Phone

PLEASE PLACE A CHECK BY YOUR RESPONSE OR PROVIDE THE APPROPRIATE INFORMATION.

Are you interested in: Temporary Permanent Placement Part Time

How did you hear about us? Classified Ad Friend Radio Internet

Minimum Hourly Pay

Minimum Annual Pay

Annual Pay Desired

Have you ever been convicted of a felony, convicted of a misdemeanor involving dishonesty or moral turpitude, or convicted in a military court martial? (A conviction will not automatically bar you from employment)

Yes No

If Yes, Please Explain

Is it legal for you to work in this country? Yes No

Desired Start Date

What hours do you prefer to work? Full-Time Part-Time Full-Time 2nd Shift Full-Time 3rd Shift Weekend Days

Will you work in a non-smoking environment? Yes No

Can you work at locations not accessible by public transportation? Yes No

COMPLETE THIS SECTION IF YOU ARE LOOKING FOR A PERMANENT POSITION.

Position Desired

Would you consider a position involving relocation, even at your own expense? Yes No

If Yes, List Location Preferences

COMPLETE ALL ITEMS THAT ARE APPLICABLE.

If presently employed, next salary review date:

Date of Last Increase

Amount of Last Increase

What is the name of your current employer?

What % Will You Travel? None To 25 % To 50 % To 100 %

PLEASE LIST YOUR WORK EXPERIENCE BELOW. (LAST JOB FIRST)

Company Name

City

Phone Number

Supervisor's Name

What does the company do?

Position or Duties

Reason for Leaving

Salary/Pay Rate

Bonus

Start Date

End Date

Company Name

City

Phone Number

Supervisor's Name

What does the company do?

Position or Duties

Reason for Leaving

Salary/Pay Rate

Bonus

Start Date

End Date

Company Name

City

Phone Number

Supervisor's Name

What does the company do?

Position or Duties

Reason for Leaving

Salary/Pay Rate

Bonus

Start Date

End Date

Company Name

City

Phone Number

Supervisor's Name

What does the company do?

Position or Duties

Reason for Leaving

Salary/Pay Rate

Bonus

Start Date

End Date

RELEVANT EDUCATION (LIST MOST RECENT FIRST)

College/School

City

Degree

Major

GPA

Graduate? Yes No

Other Educational Information

College/School

City

Degree

Major

GPA

Graduate? Yes No

Other Educational Information

College/School

City

Degree

Major

GPA

Graduate? Yes No

Other Educational Information

PROFESSIONAL CERTIFICATIONS, AFFILIATIONS AND/OR LICENSES (INDICATE STATE)

Professional Certifications, Affiliations and/or Licenses (indicate state)

REFERENCES

Name

Relationship

Company

Phone

Name

Relationship

Company

Phone

Name

Relationship

Company

Phone

General: I have submitted the attached form to the company for the purpose of obtaining permanent, temporary, or contract employment. I understand that I will never be charged a fee by the company. I acknowledge that the use of this form, and my filling it out, does not indicate that any positions are open, nor does it obligate the company to further process my application. I certify as to the accuracy of the matters set forth herein and in my resume and understand that any misstatement of fact may cause me to be refused employment or to lose my employment.

Yes No

References: I hereby authorize the company and its agents to make such investigations and inquires into my employment and educational history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, and other persons from all liability in responding to inquires connected with my application and I specifically authorize the release of information by any schools, businesses, individuals, services or other entities listed by me in this form. Furthermore, I authorize the company and its agents to release any reference information to clients who request such information for purposes of evaluating my credentials and qualifications.

Yes No

Do you have any friends who might like to apply with us? If so, please provide names and phone numbers.

Name

Phone

Name

Phone

Top