Safety Unitherm

APPLICATION FOR EMPLOYMENT

CONFIDENTIAL

ALCOHOL/DRUG ABUSE POLICY STATEMENT

We have a responsibility to provide a safe working environment for our employees, along with reliable and safe service to our customers. Therefore employees must be physically and mentally fit to perform their duties in a safe and efficient manner.
The Company is committed to provide a safe and productive work environment for all employees. It is the policy of the Company that employees shall not be involved with the unlawful use, possession, sale, or transfer of drugs or narcotics in any manner which may impair their ability to perform assigned duties or otherwise adversely impact the Company's business. Further, employees shall not possess alcoholic beverages in association with the work place or during working time. The Company has implemented and enforces a policy for maintaining a work environment free from the effects of alcohol/drug abuse or other substances which adversely affect the mind or body.

All offers will be contingent upon the verification of lawful employment status as required by the Immigration Reform and Control Act of 1986. This process must be completed immediately following the offer of employment and prior to starting work.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER BY BOTH POLICY AND PRACTICE AND ABIDE BY FEDERAL AND STATE LAWS WHICH FORBID DISCRIMINATION BECAUSE OF RACE, COLOR, RELIGION, AGE, SEX, CITIZENSHIP STATUS, NATIONAL ORIGIN, HANDICAP OR VETERAN STATUS.


We E-Verify all new hires. Please assure all required documents are in order before applying.
 
NAME
Last
First
Middle
CURRENT ADDRESS
Street
City
State
Zip Code
PERMANENT ADDRESS
Street
City
State
Zip Code
Socal Security Number
Are you 18 or older? Email Address:
Do you have a legal right to work in the U.S. and can you verify this?
Have you ever been convicted of a crime? If yes, you may explain
Telephone Home Work
In emergency, notify: Name Address
  Daytime Phone
CAREER INTEREST
Type of Work Desired:
For what position are you applying? Describe briefly your qualifications for this position.
               
Salary expected  Date available 
How did you come in contact with our Company?
(Specify)
(Specify)
(Specify)
(Specify)
Have you ever worked for or applied to our Company before? If yes, explain
Branch(s) Applied to:  
CLERICAL ABILITIES (Only clerical/secretarial applicants need to complete this section)
Typing Speed WPM Dictation Speed WPM Office Machines Operated
U.S. MILITARY RECORD
Branch of Service:
Dates of Active Service: From to Highest Rank
Military Specialization & Duties
EDUCATION RECORD
Name and Location of Circle Last Year Attended Diploma/ Degree Major Course Last Year Attended
High School
College(s)
Graduate or Other
Business or Trade School
*School Activities-Clubs, Honorary Organizations, etc.
Honors, Scholarships, Awards, etc.
Publications, Thesis, etc.
Languages
Read
Write
Speak
EMPLOYMENT HISTORY (Give last position first.)
Name of Company Address
Starting Position Date Salary
Last Position Date Salary
Duties
Reason for Leaving
Name of Last Supervisor May we contact this company?
 
Name of Company Address
Starting Position Date Salary
Last Position Date Salary
Duties
Reason for Leaving
Name of Last Supervisor May we contact this company?
 
Name of Company Address
Starting Position Date Salary
Last Position Date Salary
Duties
Reason for Leaving
Name of Last Supervisor May we contact this company?
 
Name of Company Address
Starting Position Date Salary
Last Position Date Salary
Duties
Reason for Leaving
Name of Last Supervisor May we contact this company?
 
Name of Company Address
Starting Position Date Salary
Last Position Date Salary
Duties
Reason for Leaving
Name of Last Supervisor May we contact this company?
Use the space below to list clubs/professional organizations to which you belong and any other information you desire concerning your background and abilities (e.g., hobbies, community activities).
 
Please use this section to provide any additonal information
 
To allow the Company to monitor the applicant flow, hiring and placement of protected classes in compliance with our affirmative action commitment, we would appreciate your voluntarily completing this section. This information will be removed from the application immediately upon receipt.
DATE OF BIRTH // (month/day/year)  
RACE


 
SEX
 
Are you a veteran with a disability rating of 30% or more or were you discharged or released from active duty Yes for a disability incurred or aggravated in the line of duty?
Did you serve on active duty for at least 180 days, any part of which occurred between 8/5/64 and 5/7/75 (Vietnam Era Veteran)?
Do you have a handicap or other limiting condition which would restrict or affect your ability to perform the job for which you are applying?
If yes, will you require any sort of accommodations from the company to enable you to perform the job properly and safely?
REFERRAL SOURCE








GENERAL 
BY SUBMITTING THIS APPLICATION, I AGREE TO AND ACCEPT THESE TERMS AND CONDITIONS:

I CERTIFY THAT ALL INFORMATION GIVEN ON THIS APPLICATION IS TRUE AND CORRECT. I UNDERSTAND THAT ANY MISREPRESENTATION OR OMISSION OF INFORMATION DURING ANY PART OF THE EMPLOYMENT PROCESS WILL LEAD TO REJECTION OF MY APPLICATION OR, IF I AM HIRED, WILL BE SUFFICIENT CAUSE FOR MY TERMINATION.

I UNDERSTAND THAT THE COMPANY MAY MAKE INQUIRIES RELATIVE TO MY WORK AND PERSONAL HISTORY. I AUTHORIZE THE RELEASE OF THIS INFORMATION, AND I RELEASE ANY PERSONS OR AGENCIES AND THE COMPANY FROM ANY LIABILITY IN THAT REGARD.

IN THE EVENT OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE RULES, POLICIES AND PROCEDURES OF THE COMPANY. I UNDERSTAND THAT THIS EMPLOYMENT APPLICATION IS NOT A CONTRACT OF EMPLOYMENT – ANY INDIVIDUAL WHO IS HIRED MAY VOLUNTARILY LEAVE EMPLOYMENT AND THAT INDIVIDUAL’S EMPLOYMENT AND COMPENSATION MAY BE ALTERED OR TERMINATED BY THE EMPLOYER AT ANY TIME, WITH OR WITHOUT NOTICE AND WITH OR WITHOUT CAUSE. I UNDERSTAND THAT NO REPRESENTATIVE OF THE COMPANY, OTHER THAN AN OFFICER OF THE COMPANY, HAS AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME OR TO MAKE ANY AGREEMENT, WHETHER WRITTEN OR ORAL, WHICH MODIFIES THE FOREGOING.
You may attach a resume as a PDF, DOC or DOCX file.