Lakeside Plastics | Oshkosh WI

Personal Info

Personal Information

Full Name *

Previous/Other Name(s)

Date Available to Begin Work *

Email Address*

Address *

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Phone Home or Cell *

Phone Work

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Salary Desired *

Please Indicate What Shifts/Days You Are NOT ABLE To Work *

How Many Hours A Week Are You Able To Work? *

Are You 18 Years Old or Older? *

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Education/Skills

Education

High School/G.E.D Name and Location: *

Did you graduate: *

College or University Name and Location:

Degree:

Date Received:

Major:

Date Minor:

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Degree:

Date Received:

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Date Minor:

Other School Name and Location:

Degree:

Date Received:

Major:

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Employment

If You Do Not Have Previous Employment History Type NONE In Required Fields.

EMPLOYMENT

Employer's Name:*

Address:*

Your Position:*

Phone:*

Start Date:*

End Date:

Reason for leaving:*

Employer's Name:

Address:

Your Position:

Phone:

Start Date:

End Date:

Reason for leaving:

Employer's Name:

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Other Information

Do You Know Anyone Or Are You Related To Anyone Currently Working For Lakeside Plastics, Inc.? *

If Yes, Please List Individuals:

Have you ever been convicted of, pleaded guilty or no contest to, been placed on probation, fined, imprisoned or incarcerated, or paroled for any offense (e.g., felony, misdemeanor, ordinance violation or forfeiture) other than minor traffic violations? (Note: A conviction will not automatically bar your employment.) *

If Yes, Please Explain (Include State/Country & Date Of Incident):

Are You Currently Authorized To Work For Any Employer In The United States Without Sponsorship? *

Please answer the following question only if the position(s) you applied for may require that you drive your own vehicle:
Do you have a valid driver's license?

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I certify that my answers to the foregoing questions are complete, true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application form or during any interviews, or any material omission of information on this application form will be grounds for my immediate discharge.

I understand and agree that any offer of employment that I may receive from Lakeside Plastics, Inc. is contingent upon my successful completion of its total pre-employment screening process.

In processing my application for employment, and, if I am employed, for other employment purposes, Lakeside Plastics, Inc., are hereby authorized to verify all of the information provided by me, and to procure or have prepared a consumer or an investigative consumer report for this purpose concerning, among other things, my prior employment or military record, education, character, general reputation, personal characteristics, criminal record, and mode of living. I hereby release Lakeside Plastics, Inc. and any agent(s) acting on their behalf, from any and all liability of any nature related to their requesting of such information. I also hereby release any individual or company contacted in connection with any such verification or investigation process from any and all liability of any nature related to their statements in response to such questioning, including, but not limited to, any claims of defamation or invasion of privacy.

I understand that Lakeside Plastics, Inc., in compliance with the Immigration Reform and Control Act of 1986, will hire only individuals legally authorized to work in the United States. I agree to provide proof of my legal ability to work upon an offer of employment.

I agree that, if I am employed, I will abide by all rules and regulations of Lakeside Plastics, Inc. I further understand that unless specifically agreed to in a written Employment Agreement between Lakeside Plastics, Inc. and myself, that if I become employed by Lakeside Plastics, Inc., my employment will be "at will", meaning that either party may terminate our employment relationship at any time, with or without cause. No employee of Lakeside Plastics, Inc. may make any oral representations or oral commitments to the contrary.

I have read and understand this Applicant's Statement and attest that all representations made herein are accurate and complete with no incidental omissions.

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Please Answer This Math Problem to Veryify That You Are Not a Robot: 12 + 10 = *

(*) Required Fields

Employment Application

Personal Info

Personal Information

Education/Skills

Education

Employment

EMPLOYMENT

Other Information

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