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© 2019 King Plastic Corporation.

Name *

First

Last

Title *

Company Name / Organization *

Address *

Address Line 1

City

State

Zip Code

Email *

Phone *

How did you hear about us? *

Product *

Message *

Website

- Step 1 of 4

Attention Applicants: You must be at least 18 years of age. The information supplied on this application is subject to verification. Employment with King Plastic Corporation is subject to satisfactory work history, personal reference reports and background checks from outside agencies.

Qualified applicants receive equal consideration. No question is asked for the purpose of excluding any applicant due to race, creed, color, gender, national origin, religion, age, disability, veteran, or marital status or on the basis of any other condition or characteristic protected by federal, state or local law. King Plastic Corporation is an equal opportunity employer and intends to comply fully with all federal and state laws. The information requested on this application will not be used for any purpose prohibited by law.

King Plastic Corporation requires applicants to undergo screening for the presence of illegal drugs/and or alcohol as a condition of employment.

Position applying for *

PERSONAL DATA

Name *

First

Middle

Last

Address

Address Line 1

City

State

Zip Code

Home Phone

Cell Phone

Email

How did you hear about job openings at King Plastic Corporation? (Check all that apply) *

Referred by King Plastic Employee
Walk in
Social Media (Facebook)
Newspaper
Radio
Indeed
Other

Other - Please indicate how you learned about job openings at King Plastic Corporation *

Referred by King Plastic employee - please type his or her name *

Desired Salary

Please indicate per hour or per year

DAY Shift Availability - (Check all that apply)

Sunday - Days
Monday - Days
Tuesday - Days
Wednesday - Days
Thursday - Days
Friday - Days
Saturday - Days

NIGHT Shift Availability - (Check all that apply)

Sunday - Nights
Monday - Nights
Tuesday - Nights
Wednesday - Nights
Thursday - Nights
Friday - Nights
Saturday - Nights

Shift Preference

Days
Nights

Have you applied here before?

Yes
No

If yes, when?

Where you interviewed?

Yes
No

Do you have reliable transportation to work (overtime can be manatory and sporadic)? *

Yes
No

Please list any friends or relatives working for King Plastic Corporation and their relationship to you:

Are you able to perform the following functions with or without accommodation?

Light lifting (1-25 lbs) *

Yes
No

Are you able to perform these functions with or without accommodation?

Moderate lifting (26-49 lbs) *

Yes
No

Are you able to perform these functions with or without accommodation?

Heavy lifting (50+ lbs) *

Yes
No

Are you able to perform these functions with or without accommodation?

Standing for 11.5 hours *

Yes
No

Are you able to perform these functions with or without accommodation?

Working in a high heat environment *

Yes
No

Are you able to perform these functions with or without accommodation?

Wearing protective equipment (safety shoes, glasses, face shields, etc.) *

Yes
No

Are you able to perform these functions with or without accommodation?

Bending, stooping *

Yes
No

Are you able to perform these functions with or without accommodation?

Climbing *

Yes
No

Are you able to perform these functions with or without accommodation?

Repetitive motion *

Yes
No

Are you able to perform these functions with or without accommodation?

Push/pull with arms/legs *

Yes
No

Are you able to perform these functions with or without accommodation?

If hired, can you submit documentation verifying that you are legally eligible to work in the United States? *

Yes
No

EMPLOYMENT HISTORY

Work history information is used to determine whether you qualify for the job for which you are applying. Please complete in DETAIL beginning with the MOST RECENT employer. Include summer employment, U.S. Military experience, periods of unemployment or self-employment, show dates (month/year) and locations. You may attach a resume for an explanation of the duties but you are still required to complete all information requested. If additional space is required, attach a second sheet.

Incomplete applications will not be considered.

Have you ever been discharged or forced to resign from a job?

Yes
No

If yes, please explain

Did you receive any discipline in the last 18 months of employment?

Yes
No

If yes, please explain

Have you signed a non-compete agreement with your current/previous employer?

Yes
No

If yes, give details

EMPLOYER 1

Current or Most Recent

Employer

Position Title

Currently employed here?

Yes
No

Start Date *//

Month and Year is acceptable

End Date *//

Month and Year is acceptable

Address

Address Line 1

City

State

Zip Code

Supervisors Name

Phone

What type of industry is this employer?

Manufacturing
Retail
Service
Other

Duties

Average hours per week

Salary

Please indicate per hour or per year

Per Hour
Per Year

Reason for Leaving

EMPLOYER 2

Add Employer 2 History? *

Yes
No

Employer

Position Title

Start Date *//

Month and Year is acceptable

End Date *//

Month and Year is acceptable

Address

Address Line 1

City

State

Zip Code

Supervisors Name

Phone

What type of industry is this employer?

Manufacturing
Retail
Service
Other

Duties

Average hours per week

Salary

Please indicate per hour or per year

Per Hour
Per Year

Reason for Leaving

EMPLOYER 3

Add Employer 3 History? *

Yes
No

Employer

Position Title

Start Date *//

Month and Year is acceptable

End Date *//

Month and Year is acceptable

Address

Address Line 1

City

State

Zip Code

Supervisors Name

Phone

What type of industry is this employer?

Manufacturing
Retail
Service
Other

Duties

Average hours per week

Salary

Please indicate per hour or per year

Per Hour
Per Year

Reason for Leaving

EMPLOYER 4

Add Employer 4 History? *

Yes
No

Employer

Position Title

Start Date *//

Month and Year is acceptable

End Date *//

Month and Year is acceptable

Address

Address Line 1

City

State

Zip Code

Supervisors Name

Phone

What type of industry is this employer?

Manufacturing
Retail
Service
Other

Duties

Average hours per week

Salary

Please indicate per hour or per year

Per Hour
Per Year

Reason for leaving

EMPLOYER 5

ADD EMPLOYER 5 HISTORY? *

Yes
No

Employer

Position Title

Start Date *//

Month and Year is acceptable

End Date *//

Month and Year is acceptable

Supervisors Name

Phone

Address

Address Line 1

City

State

Zip Code

What type of industry is this employer?

Manufacturing
Retail
Service
Other

Duties

Average hours per week

Salary

Please indicate per hour or per year

Per Hour
Per Year

Reason for leaving

EDUCATION

High School

High School Attended

Address

Address Line 1

City

State

Did you graduate?

Yes
No

Certificate

Diploma
G.E.D.
HSED

College

College Attended

Address

Address Line 1

City

State

Major

Degree

College Attended

Address

Address Line 1

City

State

Major

Degree

Vocational Training, Trade, Business, Armed Forces and other special training

School

Address

Address Line 1

City

State

Program

Certificate

Yes
No

School

Address

Address Line 1

City

State

Program

Certificate

Yes
No

SKILLS AND TRAINING

Do you have any skills/abilities not listed under “Employment History” that would further qualify you for employment? (such as: use of office equipment, power tools, specific machines operated, mechanical experience, electrical experience, hobbies, etc.) If so, what are those skills and where did you acquire them?

Skills

Computer Skills

Microsoft Outlook
Word
Excel

Other Computer Skills

Please check boxes that apply to the skills, experience, and ability that you have

Electrical
Fabrication
Router
Saw
Grinding
Inspection
Fork Lift
Semi Truck Driving
Valid CDL
Inventory
Quality Assurance
Material Handling
Shipping
Receiving
Micrometer
Tape Rule
AC Drives
DC Drives
CNC Machining
CNC Programming
AB Controls
PLC's
Welding
Extrusion

Where did you acquire these skills?

MILITARY

Branch

Duties

Honorable Discharge?

Yes
No

Did you receive specialized training?

Yes
No

If yes, please describe

REFERENCES

Are you currently employed?

Yes
No

May we contact your present employer?

Yes
No

Are any of your employment/educational records under a different last name?

Yes
No

If yes, last name

Please provide at least two references not related to you, whom you have known for at least 5 years

Name

First

Last

Relationship

Occupation

Home Phone

Work Phone

Address

Address Line 1

City

State

Zip Code

Years Acquainted

Name

First

Last

Relationship

Occupation

Home Phone

Work Phone

Address

Address Line 1

City

State

Zip Code

Years Acquainted

If yes, please state particulars *

Have you ever been convicted of any crime? *

Yes
No

NOTE: A "YES" answer will not necessarily bar you from employment. The nature, severity and date of the offence(s) will be considered in relation to the position for which you are applying.

Charge

Date

month/year

Sentence

Current Status

PLEASE READ CAREFULLY

I hereby certify that the answers given by me on this application are true and correct without significant omissions of any kind whatsoever. I understand that the falsification, misrepresentation or omission of any facts on this application or attached resume will be cause for denial of employment or if hired, immediate termination of employment, regardless of the timing or circumstances of discovery without liability to King Plastic Corporation. I authorize the companies or persons identified in the application to give any information regarding my employment, together with any information they may have regarding me, whether or not it is in their records. In addition, I hereby authorize King Plastic Corporation to contact references, persons, schools, law enforcement agencies and any other sources of information which may be relevant to my application for employment. I hereby release said contacts from all liability damage whatsoever for issuing this information. I authorize King Plastic Corporation to supply my employment record, in whole or in part, and in confidence, to any prospective employer, government agency, or other party, with a legal and proper interest and I release all parties from all liability for any damage that may result from King Plastic Corporation furnishing said information to said parties. If employed, I agree to abide by all of King Plastic Corporation’s work/safety rules, regulations, policies and procedures and understand that neither the rules, regulations, policies and procedures nor anything said during the interview process shall be deemed to constitute the terms of an implied contract. I understand that any employment offered is for an indefinite duration and is at will and that either I or King Plastic Corporation may terminate my employment at any time with or without notice or cause. This policy of at-will employment is the sole and entire agreement between me and King Plastic Corporation.

I understand that King Plastic Corporation is committed to maintaining a drug-free workplace and in applying for employment, I agree to take a pre-employment drug/alcohol test. In addition, if employed, I understand that King Plastic Corporation conducts random drug testing of its employees.

I understand that this application will remain on file for twelve months for consideration. After twelve months, if I am still interested in a position with King Plastic Corporation, it will be necessary for me to complete a new application form.

Applicant Signature *

Initials

Date

Date / Time

Date

Time

Name

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