Employment Application • Prospect Foundry

General Information

Have you ever used another name?*

Yes
No

Is any additional information relative to name changes, use of an assumed name, or nickname necessary to enable a check on your work and educational record?*

Yes
No

Please Explain*

Have you ever worked for this company before?*

Yes
No

Please give the Date & Position*

Do you have friends and/or relatives working for this company?*

Yes
No

Please provide name(s) and relationship(s):*

On what date are you available to begin work?*

Days/Hours available to work (check all that apply):*

1st Shift: 4am-2pm
2nd Shift: 2pm-12am
3rd Shift: 8pm-6am

Work Availability:*

Full-time
Part-time
Shift Work
Temporary

Minimum Salary Required*

Per Hour

If hired, would you have a reliable means of transportation to and from work?*

Yes
No

Are you at least 18 years old?*

Yes
No

Note: If under 18, hire is subject to verification that you are of minimum legal age.

Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation?*

Yes
No

Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for qualified applicants/employees to perform essential job functions.

Applicant Statement and Agreement

Please read and check each paragraph below. If there is anything that you do not understand, please ask.

I hereby authorize the Company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to the Company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.*

I agree

In the event of my employment with the Company, I understand that I am required to comply with all rules and regulations of the Company.*

I agree

If hired, I understand and agree that my employment with the Company is at-will, and that neither I, nor the Company is required to continue the employment relationship for any specific term. I further understand that the Company or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I understand that the at-will status of my employment cannot be amended, modified, or altered in any way by any oral modifications.*

I agree

I understand that safety of employees is extremely important to the Company and that the Company is committed to ensuring a safe working environment. I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor. I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health.*

I agree

I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.*

I agree

I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States, and that federal immigration laws require me to complete an I-9 Form in this regard.*

I agree

I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed and the remainder of this Agreement shall be enforceable.*

I agree

AGREEMENT

By signing this Employement Application, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.

Electronic Signature

First Last

Electronic Signature Date

Acknowledgement*

I understand that checking this box constitues a legal signature confirming that I acknolwedge and warrant the truthfulness of the information provided in this document.

Application for Employment

Step 1 of 7 - Candidate Information

Application for Employment

Candidate Information

Employer Information

Most Recent Employer

Employer Information - Continued

Employer Information - Continued

Employement Experiance

Education

Business References

Personal References

General Information

Applicant Statement and Agreement

AGREEMENT

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