Application for Employment

* Required
Personal Information
First Name *
Middle Name
Last Name *
Address *
City *
State * Zip Code *
Phone * Email
Position Applying For Desired Salary
Are you legally eligible for employment in the U.S.? *
Yes
No
Are you willing to work overtime when required? *
Yes
No
Are you willing to work weekends? *
Yes
No
Were you previously employed by SI Plastics? *
Yes
No
If yes, when?
Have you ever been convicted of a crime other than a minor traffic violation? *
Yes
No
If yes, please explain:
If hired, would you have transportation to/from work? *
Yes
No
When would you be available for work?
If offered a position, would you agree to a pre-employment drug screen? *
Yes
No
How did you hear about us?
Education
School Name & Address Course Of Study Years Completed Graduate?
High School
College
Other
Employment History
Name & Address Duties & Responsibilities Reason For Leaving
Job Type Position Start Date End Date Salary
Name & Address Duties & Responsibilities Reason For Leaving
Job Type Position Start Date End Date Salary
Name & Address Duties & Responsibilities Reason For Leaving
Job Type Position Start Date End Date Salary
References
Name & Address * Phone * Business * Years Known *
Additional Information
Any additional information? (250 character max)
Resume
Upload Resume (optional) .doc, .docx, .pdf
Authorization

I Agree *
I hereby give permission to contact the employers I have submitted concerning any information you deem relevant.

I Agree *
I certify that the facts submitted on this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers submitted to give you any and all information concerning my previous employement and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.
SI Plastics, Inc. is an equal opportunity employer. SI Plastics, Inc. does not discriminate in employment based on race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.
Full Name * Last 4 digits of Social Security number *