Date* MM slash DD slash YYYY I. GENERALA. NamePlease Print* Last* First* Middle* Telephone*B. Present AddressNo. & Street* City* State* Zip Code* C.Job applied for* Minimum weekly salary required* D. How did you become interested in Allied?:Want ads Relative or friend Person at Allied Highway sign Other source E. If you were known by another name at another place of employment, provide that name and dates used F. Do you have transportation to and from Allied-Locke? Yes No G. Were you ever interviewed at Allied-Locke? Yes No By whom? Personnel Director Foreman Other Explain H. Date available for employment MM slash DD slash YYYY II. PERSONALA. Are you? Over 18 Under 18 B. Are you legally able to work in the U.S.A.? Yes No Green Card No. C. Is there a person with whom we could leave a telephone message in the event of a future employment opportunity?Name Number D. Do you have any job or career goals which might be of interest to our company? E. Do you anticipate anything interfering with your regular attendance as a full-time employee here? F. Are you now or do you expect to be engaged in any other business or employment? Yes No If so, explain G. List any awards, achievements, patents, publications, leadership positions, etc., with which you have been credited EMPLOYMENT RECORDA. Were you ever employed by Allied-Locke Industries? Yes No If so, when Department Reason for leaving B. Employment historyEMPLOYMENT (PRINT)DESCRIBE WORK YOU DID (INCLUDE RESPONSIBILITIES, SUPERVISORY DUTIES, ETC.)1. Present or most recent employerName City & State Telephone No.Title of Position Held Reason for leaving Starting date MM slash DD slash YYYY Ending date MM slash DD slash YYYY Average Number of work days missed per month: One or fewer 2-4 days 5 or more 2. Next previous employerName City & State Telephone No.Title of Position Held Reason for Leaving Starting date MM slash DD slash YYYY Ending date MM slash DD slash YYYY Average Number of work days missed per month: One or fewer 2-4 days 5 or more 3. Next previous employerName City & State Telephone No.Title of Position Held Reason for Leaving Starting date MM slash DD slash YYYY Ending date MM slash DD slash YYYY Average Number of work days missed per month: One or fewer 2-4 days 5 or more 4. Next previous employerName City & State Telephone No.Title of Position Held Reason for Leaving Starting date MM slash DD slash YYYY Ending date MM slash DD slash YYYY Average Number of work days missed per month: One or fewer 2-4 days 5 or more EDUCATION AND EXPERIENCEA. What education or training have you had for the job you are applying for? (please list)B. Have you had any other education or training which might be important if you were considered for other positions with Allied-Locke? High school College Other If so, please list all relevant courses or training completed:C. Have you had any job experience or otherwise possess any of the job skills listed below? If so, please use the appropriate spaces to estimate the number of full-time months you have worked at similar positions. (for example: welding 6 months) NOTE: Not all of these skills are required of applicants for any particular position, but our awareness of your background will aid us in placing you in a job most advantageous to you and to the company.GENERAL FACTORYAgricultural chain assembly If so, please specify positions General factory work Small piece assembly Large assembly Furnace, heat-treat Riveting machine Welding Mig Tig Stick Operator of other machinery If so, please specify MAINTENANCEMachine repair, maintenance Diagnosed trouble on machines Machine set-up If so, indicate type of machines Hydraulic installation or repair Electrical installation 110 220 440 Electrical repair Electronics Heating systems Air-conditioning systems Plumbing Painting Work at heights, on ladders PUNCH PRESSES, STAMPING MACHINESManual punch press Automatic press Progressive-die press Punch press set-up Progressive-die set-up OTHER MECHANICAL SKILLSFarming Automotive engine repair Other engine repair Other - specify PRODUCTION TURNING & MILLINGCNC Lathe CNC Mill CNC VTL CNC Flame Cut CNC Plasma Cut SHIPPING/RECEIVINGShipping, warehouse Material handling Fork-lift driving TOOL ROOMOperated lathe Operated mill Operated grinder Operated boring machine Operated drill press Other Read blueprints Used gauges/measuring instruments SUPERVISORY SKILLSInspection, quality control Group leader, assistant foreman Other supervisory position (list, specify no. of people) D. Have you served in the U.S. Armed Forces? Yes No Branch From To Starting rank Ending Service schools or special experience If you have taken any training under the G.I. Bill of Rights, please describe E. Do you have any special interests or hobbies in the areas of Electronics Metal Work Mechanics Other Explain F. Use this space to tell us any additional information about yourself:PERSONAL REFERENCES (Not former employers or relatives)ReferencesNameAddressPhoneRelationship to you Δ
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