Employment Application

Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job-related medical condition or handicap.

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Applicant Information
Fields designated with an asterisk (*) are required:
Name: *
Name:
Address: *
Address:
Telephone *
Telephone
Additional Applicant Information
Give name, address, and telephone number of two references whoa re not related to you and are not previous employees:
Referral Source:
Friend/Relative employed by Select Industries Corp. (if applicable):
Friend/Relative employed by Select Industries Corp. (if applicable):
Date of previous employment with company (if applicable):
Date of previous employment with company (if applicable):
Shift availability:
Check any box that you are available to work.
When are you able to begin working?
When are you able to begin working?
References
Please provide name, address, and telephone number for two separate references who are not related to you and are not previous employers:
Name
Name
Reference 1
Address
Address
Reference 1
Telephone
Telephone
Reference 1
Name
Name
Reference 2
Address
Address
Reference 2
Telephone
Telephone
Reference 2
Education
Employment Experience
Start with your current or most recent job. Include military service assignments and volunteer activities. Exclude organization names which indicate race, color, sex, or national origin.
Experience 1
Company address:
Company address:
Experience 1
Company phone:
Company phone:
Experience 1
Experience 1
Experience 1
Experience 1
Experience 1
$
Experience 1
$
Experience 2
Company address:
Company address:
Experience 2
Company phone:
Company phone:
Experience 2
Experience 2
Experience 2
Experience 2
Experience 2
$
Experience 2
$
Experience 3
Company address:
Company address:
Experience 3
Company phone:
Company phone:
Experience 3
Experience 3
Experience 3
Experience 3
Experience 3
$
Experience 3
$
Special Skills and Qualifications
List all skills and qualifications acquired from previous employment below.
Assessment
Please answer the following questions (if applicable).
Application Agreement
The information provided in this application for employment is true, correct, and complete. I agree that, if employed, any false or misleading statements or omissions in this application may result in my dismissal, whenever discovered. I agree that, if hired, my employment is for no definite period and may be terminated at will at any time for any reason by either me or Select International Corp. I agree that this cannot be changed except in writing by the Company President, and that any representations to the contrary are not binding on Select International Corp. I authorize a medical examination, including a drug screen, by an examiner selected by Select International Corp. I understand that the company may obtain or prepare an investigative consumer report in connection with my application. I authorize any reference, school, hospital, doctor, or former employer to disclose to Select International Corp. upon request any information they may have about me and I release them from all liability for disclosing such information to Select International Corp.
Please type your First and Last Name
Terms of Acceptance and Signature *