Employment Application

Name & Location

Name*

First Last

Application Date*

Phone Number*

Street Address Address Line 2 City State ZIP Code

Employment Desired

Position Applying For*

Referred By

Are you willing to work any shift?*

Yes
No

What shift are you available?*

Are you willing to work overtime?*

Yes
No

Education

Last High School*

Did you graduate?*

Yes
No

Jr. College, College or University

Academic Major

Number of years

Did you graduate?

Yes
No

Other experience or training including audit education programs which have been on the job you are seeking.

School Name

Course

Diploma/Certification

Date Completed

Employment History

List most recent employer first.

Date From

Date To

Employer

Employer Address

Street Address Address Line 2 City State ZIP Code

Employer Phone

Reason for leaving

Date From

Date To

Employer

Employer Address

Street Address Address Line 2 City State ZIP Code

Employer Phone

Reason for leaving

Date From

Date To

Employer

Employer Address

Street Address Address Line 2 City State ZIP Code

Employer Phone

Reason for leaving

References

May we contact your present employer for a reference?*

Yes
No

Reference Name*

First Last

Occupation /Title*

Phone*

Reference Name*

First Last

Occupation/Title*

Phone*

Applicant Notification

I state that the information contained in the foregoing statements is true and correct. I understand that if I am employed, any misrepresentation or omission or material facts on this application is sufficient cause for dismissal. I agree that, if hired, I will conform to the rules and regulations of NSI Crankshaft and further agree that my employment is for no definite period of time and can be terminated, with or without cause, and with or without notice any time, at the option of either NSI Crankshaft or myself. I understand that neither the Employee Rules, Policies, and Benefits, nor any other written or oral statement by NSI Crankshaft or its representatives are contacts or employment. No employee of NSI Crankshaft, other than the President, has any authority to enter into any agreement for employment for any specified time, or to make any agreement contrary to the foregoing, and no such agreement has been made. NSI Crankshaft, in considering my application for employment, may verify the information set forth on this application and obtain additional information relating to my background. This inquiry includes information as to your character, general reputation, personal characteristics, and mode of living. You have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of this investigation. I authorize all persons, schools, companies, corporations, credit bureaus, consumer reporting agencies, and law enforcement agencies to supply any information concerning my background. If, at the time of termination, I am for any reason indebted to NSI Crankshaft, whether for merchandise, cash advances, withdrawals, or otherwise, I agree that NSI Crankshaft shall have the right to make the necessary deductions and withhold from any remuneration or from any reimbursement to which I may be entitled, and amount of sufficient to fully cover and completely pay for all of my indebtedness. I further promise and agree to observe all NSI Crankshaft rules and regulations, and to faithfully perform all duties that may be assigned to me.

I have read and agree with the terms and conditions above*

Agree

Employment Application

Apply Now

Name & Location

Employment Desired

Education

Employment History

References

Applicant Notification

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