CapabilitiesMetal Stamping ServicesDesigning & Testing ServicesGlobal Sourcing OptionsPast ProjectsPowdered Metal to Metal Stamping Conversion of an ABS Assembly for the Automotive IndustryManufacturing Process Improvement for a Solar Industry ComponentProduct Localization for Transplanted OEM'sExpanding Globally With Our CustomerEngineering & Metal Stamping of a Mounting Bracket for the Safety Restraint Industry

                             
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Application For Employment


An equal opportunity employer

A.J. Rose is an equal opportunity employer and is dedicated to promoting a workplace free of unlawful discrimination.  A.J. Rose does not discriminate against applicants or employees on the basis of sex, race, color, religion, national origin, ancestry, age, disability, veteran status, or any other status protected by law.

Personal Information-Please fill in all information
DATE:
Last Name First Name: Middle Name
Address City State Zip
Home Phone # Work Phone # Cell Phone #
Are you legally eligible to work in the USA? Yes No Have you ever worked for us before? Yes No

Do you have any friends or family working for us? Yes No   If yes, whom?

Have you ever been convicted of a crime other then a minor traffic violation (A conviction will not necessarily be a bar to employment)? Yes No
If you answered yes to the above question, please explain:

Name and address of person to notify in case of an emergency:

Name      Day #      Evening #

Address      Relationship

Are you over 18 years old? Yes No Position of Interest:

         Do you have an Email Address:        Are you willing to work any shift? Yes No

Date you can start:        Rate of pay expected:  

 

Education Information


Name & Address of school Course of Study Did you graduate ?
High School Yes No
College Yes No
Other (specify) Yes No
Other (specify) Yes No
If you did not graduate, do you have a GED? Yes No
Special Skills
List any special skills or machinery you can operate:

Employment History-Please give accurate and complete full-time and part-time employment record. Start with your present or last employer.

1#
Company Name Address
Phone number Supervisor
Job Title May we contact them? Yes No
Description of Duties:
Start Date End Date
Starting salary Ending Salary
Reason for leaving:
2#  Second Employer click here
Company Name Address
Phone number Supervisor
Job Title May we contact them? Yes No
Description of Duties:
Start Date End Date
Starting salary Ending Salary
Reason for leaving:
3#  Third Employer click here
Company Name Address
Phone number Supervisor
Job Title May we contact them? Yes No
Description of Duties:
Start Date End Date
Starting salary Ending Salary
Reason for leaving:

References(Not family members or members of your household)

1#
Name: Relationship:
Occupation Phone Number
Length of association  
2#  Second Employer click here
Name: Relationship:
Occupation Phone Number
Length of association  
3#  Third Employer click here

Name: Relationship:
Occupation Phone Number
Length of association  

How did you hear about A.J. Rose?     

Please upload resume

I certify that I have completed this application truthfully and accurately, and I understand and agree that I will be subject to immediate discharge should A.J. Rose discover any of my representations contained in this employment application to be false, incomplete, or misleading.

Applicants Initials Date

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