Form

Application for Employment Valid Documents Required for Employment

What position / positions are you interested in? *

Date you can start*

Year/Month/Day

First name*

Last name*

Email*

Phone number*

Street address*

Street Address 2

City*

State/Region*

Postal Code*

Are you eligible to work in the U.S.?*

Yes

Are you at least 18 years or older? (If no, you may be required to provide authorization to work)*

Yes

Have you ever been terminated from employment or asked to resign by and employer?*

Yes

If Yes, please provide company names and details.

Can you work any shift? *

Yes

Can you read and write English?*

Yes

Can you work overtime, including weekends? *

Yes

Are you currently employed?*

Yes

If yes, may we contact your current employer?*

Yes

How did you hear about us?*

Have you ever worked for this company before?*

Yes

If yes, explain.

Do you know anyone who works for this company?*

Yes

Is yes, who?

Education*

Name of School*

No. of Years Attended*

Degree Received*

Subjects Studied / Major*

Education 2

Name of School 2

No. of Years Attended 2

Degree Received 2

Subjects Studied / Major?

EMPLOYMENT HISTORY Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

From*

Year/Month/Day

To*

Year/Month/Day

Employer Name*

Employer Address*

Position / Title*

Supervisor Name & Title*

Duties / Responsibilities*

Reason for Leaving*

From 2

Year/Month/Day

To 2

Year/Month/Day

Employer Name 2

Employer Address 2

Position / Title 2

Supervisor 2 Name & Title

Duties / Responsibilities 2

Reason for Leaving 2

From 3

Year/Month/Day

To 3

Year/Month/Day

Employer Name 3

Employer Address 3

Position / Title 3

Supervisor 3 Name / Title

Duties / Responsibilities 3

Reason for Leaving 3

From 4

Year/Month/Day

To 4

Year/Month/Day

Employer Name 4

Employer Address 4

Position / Title 4

Supervisor 4 Name / Title

Duties / Responsibilities 4

Reason for Leaving 4

Do you have any special skills, experience, and/or training that would enhance your ability to perform the position applied for? List any computer skills as well. *

Yes

If yes, please explain.

REFERENCES Give the names of three persons not related to you, whom you have known at least three (3) years.

Reference 1 Name*

Reference 1 Email*

Reference 1 Phone*

Reference 1 Company*

Years Known 1*

Reference 2 Name*

Reference 2 Email*

Reference 2 Phone*

Reference 2 Company*

Years Known 2*

Reference 3 Name*

Reference 3 Email*

Reference 3 Phone*

Reference 3 Company*

Years Known 3*

Please read carefully before Submitting.

Cleanroom Film and Bags (CFB) is an equal opportunity employer. CFB does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex, sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service (For any applicable states, or based upon sexual orientation, gender identity and or gender expression).

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for CFB to hire me. If I am hired, I understand that either CFB or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of CFB has the authority to make any assurance to the contrary.

I attest that by submitting I have given to CFB true and complete information on this application. No requested information has been concealed. I authorize CFB to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Today's Date*

Year/Month/Day

Full Name*