JOB APPLICATION - 2024 | Midstates Precast Pr

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PERSONAL INFORMATION

Full Name

Email Address

Phone Number

Address Line 1

Address Line 2

DESIRED EMPLOYMENT

Desired Start Date

Desired Salary

Are you currently employed?

Yes

If employed, may we inquire of your current employer?

Yes

Are you eligible for employment in the United States?

Yes

Have you plead "guilty" or "no contest" to, or been convicted of fraud, breach of trust (theft), assaut or a felony?

Yes

Answering "Yes" to this question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness, nature of the violation, rehabilitation and position applied for will be considered.

Have you applied to this company before?

Yes

If so, when and which position?

Are you able to perform the essential functions of the job for which you are applying, with or without reasonble accomodations?

Yes

How did you hear about us?

Walk In

Advertisment

Referral

Other

If referral or other, elaborate

(Complete only if driving is an essential function of the job for which you are applying)

DRIVING RECORD

Is your driving record clean and free from traffic tickets, moving violations, automobile accidents and DUIs/DWI's?

Yes

EDUCATION

High School

Name & Location of School:

How many years:

Graduated?

Yes

University/College Undergraduate:

Name & Location of School:

How many years:

Degree:

Graduated?

Yes

Trade, Business or Correspondence School:

Name & Location of School:

How many years:

Degree:

Graduated?

Yes

Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying:

EMPLOYMENT HISTORY

(past seven years)

Employer A:

Job Title:

Address:

Phone:

Date From:

Date To:

Salary:

Duties

Reason for Leaving:

Employer B:

Job Title:

Address:

Phone:

Date From:

Date To:

Salary:

Duties

Reason for Leaving:

Employer C:

Job Title:

Address:

Phone:

Date From:

Date To:

Salary:

Duties

Reason for Leaving:

REFERENCES

Reference 1 - Name:

Phone:

Address:

Occupation

Relationship:

Years Known:

Reference 2 - Name:

Phone:

Address:

Occupation

Relationship:

Years Known:

I certify that all information I have provided in order to apply for and secure work with Midstates Precast Products, Inc is true, complete and correct.

I expressly authorize, without reservation, Midstates Precast products, Inc, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding Midstate Precast Products, Inc, its agents, employees or representatives for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand Midstates Precast Products, Inc. is an equal opportunity employer and does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status, or unfavorable discharge from military service.

If I am hired, I understand that Midstates Precast Products, Inc is an at-will company and I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law.
This application or any verbal communication does not constitute an agreement or contract for employment for any specified period unless it is in writing and signed by the employer’s president.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer’s service, whenever it is discovered.

Do not sign until you have read the above application statement.

Applicant Signature:

Thank you for applying with Midstates Precast Products. We'll be in touch.