Job Application for "Factory Production Line"

Notice: If you are hired, you will be required to provide proof of identity and legal work authorization.
First Name(*)
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Middle Name
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Last Name(*)
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Address(*)
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City(*)
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State(*)
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Home Phone(*)
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Mobile Phone(*)
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Are you 18 or older?(*)
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Are you able to perform the tasks of the position without seeking accommodations?(*)
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How would you perform these tasks and with what accommodations?
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Are you willing and able to work holidays and weekends?(*)
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Do you have any restrictions on working overtime?(*)
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Availability (please check all that apply)(*)
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Date Available(*)
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Briefly summarize/describe your work experience(*)
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Upload a Resume
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Employment History

In the space below account for all of the time in the past 10 years (whether working or not). Start with your most recent experience and work backwards. Include military service and any periods of unemployment. Give complete names and addresses. If self-employed, give firm name.
Employer 1
To (month/year)
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From (month/year)
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Employer Name & Address
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Position Held
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Supervisor Name
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Phone
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Reason for leaving:
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Employer 2
To (month/year)
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From (month/year)
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Employer Name & Address
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Position Held
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Supervisor Name
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Phone
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Reason for leaving:
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Employer 3
To (month/year)
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From (month/year)
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Employer Name & Address
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Position Held
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Supervisor Name
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Phone
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Reason for leaving:
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Employer 4
To (month/year)
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From (month/year)
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Employer Name & Address
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Position Held
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Supervisor Name
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Phone
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Reason for leaving:
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Employer 5
To (month/year)
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From (month/year)
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Employer Name & Address
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Position Held
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Supervisor Name
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Phone
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Reason for leaving:
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High School
Name & Address
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Graduate
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College / University
Name & Address
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Major / Field
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Graduate
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Graduate / Technical or Business School
Name & Address
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Major / Field
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Graduate
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Military Service
From (month/year)
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To (month/year)
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Branch
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Rank
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Describe any special training or courses you have had relating to the position or type of work you are seeking:
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Give a brief statement describing why you qualify for position or type of work you are seeking:
(*)
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Have you ever been employed by us before?(*)
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If yes, when?(*)
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If employed, do you have adequate transportation to and from work?(*)
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Certification, Authorization, Release & Waiver
Read Carefully Before Signing

I understand that any falsification or willful omission of fact made in the application or in connection with any background investigation may be sufficient grounds for rejection of this application, or, if discovered after an offer of employment, for immediate dismissal.

I give the employer the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability El Pinto and its representatives for seeking, gathering, and using such information and all other persons, corporations or organizations for furnishing such information. El Pinto reserves the right to conduct Internet searches in connection with candidates for employment.

I understand that my employment and compensation is "at will" in that I can be terminated with or without cause, and with or without notice, at any time, at the option of El Pinto or myself, except as otherwise provided by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no representative of the employer, other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer.

I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization.

I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.

By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
Full Name / Signature(*)
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Date(*)
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Are you a human?
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