Doyle Shamrock Industries

We are an equal-opportunity employer. To apply for a job at Doyle Shamrock Industries, please fill out the online form below. If you have a printer, alternatively you may download and print our employment application, fill it out, and then return it to us.

OFFICE USE ONLY
INTERVIEW______________ SHIFT_____________TRAINING____________START____________
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APPLICATION FOR EMPLOYMENT
WE ARE AN EQUAL OPPORTUNITY EMPLOYER AND DO NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE, MARITAL STATUS, VETERANS STATUS, HANDICAP OR DISABILITY.

NOTE- the items marked with a red asterisk are required fields.
Date *
PERSONAL INFORMATION
Name (First, Middle Initial, Last) *
Present Address (#/Street, City, State, Zip Code) *
Phone *
Social Security # *
If you are under 18 years of age, do you have a work permit?

YES NO
If NOT an U.S. Citizen, do you have the legal right to remain permanently and work in the U.S.?

YES NO
Have you ever been discharged or asked to resign by an employer? *

YES NO
If yes, please explain:
How did you hear about Doyle Shamrock?
If a referral, who referred you?
_____________________________________________________________
A RECORD OF CRIMINAL CONVICTION WILL NOT NECESSARILY BE A BAR TO EMPLOYMENT, SINCE THE COMPANY WILL CONSIDER FACTORS SUCH AS AGE, TIME OF THE OFFENSE, THE NATURE AND SERIOUSNESS OF THE VIOLATION, AND EVIDENCE OF REHABILITATION IN MAKING ANY EMPLOYMENT DECISION.
Have you ever been convicted of a crime, other than minor traffic violations? *

YES NO
If yes, please explain:
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EMPLOYMENT DESIRED
Position(s) Applied For:
Date available to start: *
AVAILABILITY (Check all that apply): *

1st Shift 7:00am-3:00pm 2nd Shift 3:00pm-11:00pm 3rd Shift 11:00pm-7:00am ALL SHIFTS
Have you ever worked for this facility before? *

YES NO
If yes, when?
If yes, who was your supervisor?
If yes, reason for leaving?
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EMPLOYMENT HISTORY
LIST BELOW YOUR WORK EXPERIENCE (START WITH YOUR PRESENT OR MOST RECENT EMPLOYER) FOR THE LAST FIVE YEARS OR YOUR LAST THREE EMPLOYERS, WHICHEVER WILL PROVIDE US WITH THE GREATEST INFORMATION ABOUT YOU. PLEASE ACCOUNT FOR ALL PERIODS OF UNEMPLOYMENT IN THIS SECTION.
COMPANY NAME & PHONE #:
Address (#/Street, City, State):
Employment start date/end date:
Supervisor name:
Rate of pay (Start/finish):
Title and Duties:
Reason for leaving:
_____________________________________________________________
COMPANY NAME & PHONE #:
Address (#/Street, City, State):
Employment start date/end date:
Supervisor name:
Rate of pay (Start/finish):
Title and Duties:
Reason for leaving:
_____________________________________________________________
COMPANY NAME & PHONE #:
Address (#/Street, City, State):
Employment start date/end date:
Supervisor name:
Rate of pay (Start/finish):
Title and Duties:
Reason for leaving:
_____________________________________________________________
Explanation for unemployment:
MAY WE CONTACT YOUR PRESENT EMPLOYER AT THIS TIME? *

YES NO
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REFERENCES:
LIST THE NAMES OF ANY PROFESSIONAL OR PERSONAL CHARACTER REFERENCES WHO HAVE KNOWN YOU FOR AT LEAST THREE YEARS AND FROM WHOM YOU CAN OBTAIN LETTERS OF RECOMMENDATION. PLEASE DO NOT LIST RELATIVES.
NAME AND PHONE #:
ADDRESS (#/Street, City, State):
OCCUPATION:
RELATIONSHIP TO APPLICANT:
_____________________________________________________________
NAME AND PHONE #:
ADDRESS (#/Street, City, State):
OCCUPATION:
RELATIONSHIP TO APPLICANT:
_____________________________________________________________
NAME AND PHONE #:
ADDRESS (#/Street, City, State):
OCCUPATION:
RELATIONSHIP TO APPLICANT:
_____________________________________________________________
PLEASE READ CAREFULLY AND SIGN:
BY SIGNING BELOW, I CERTIFY THAT I HAVE READ, UNDERSTAND, AND AGREE TO EACH OF THE FOLLOWING STATEMENTS:
All of the information I have supplied on this application is true, accurate and complete, to the best of my knowledge, and I have not knowingly withheld any information which, if known to the company, would affect my application unfavorably.
If the Company hires me, and they discover at any time during my employment that any of the statements or answers on this application are false, misleading, or incomplete, I may be dismissed immediately from my job.
In consideration of my employment with the Company, I agree to abide by all the Company's rules and regulations.
I understand that nothing in this employment application creates a contract of employment between me and the company. If I am hired by the company, my employment and compensation are "at will", which means that my employment can be terminated, either by the company or me, with or without cause, and with or without notice. I understand that no manager or supervisor has the authority to make any employment agreement with me, either orally or in writing, that is NOT an at-will agreement. Only the President of the Company has the authority to enter into an employment agreement for any specified period of time, with me.
I give the company permission to conduct any investigation regarding the information contained in my employment application, which the company thinks is necessary to determine my qualifications for assuming a job with the company. I give the company my permission to contact any former employer, school, college or university, utility company, credit or finance bureau or office, any personal or professional reference, or any other appropriate source or individual for the purpose of gathering any information personal or otherwise, that such sources may have about my character, general reputation, credit education or employment record, and I give my consent to any such source to release to the company whatever information they have about me. I also unconditionally release all named and unnamed sources from any and all liability, which might result from furnishing any information about me.
DATE *
SIGNATURE *