Education
	School Name	Subjects Studied	City	State	Graduated?
Grammar
High School
College/University/Other
College/University/Other

General Information

Subjects of special study/interest/research. Work or special training/skills, Military

Work Experience (Current or most recent job first, then previous jobs in order)
Company Name
Address
Phone Number
Job Title:
Job Description (Be Specific):
Salary:
May we contact your supervisor/employer?
Name:
Dates of Employment From:
To:
Company Name
Address
Phone Number
Job Title:
Job Description (Be Specific):
Salary:
May we contact your supervisor/employer?
Name:
Dates of Employment From:
To:
Company Name
Address
Phone Number
Job Title:
Job Description (Be Specific):
Salary:
May we contact your supervisor/employer?
Name:
Dates of Employment From:
To:
Company Name
Address
Phone Number
Job Title:
Job Description (Be Specific):
Salary:
May we contact your supervisor/employer?
Name:
Dates of Employment From:
To:

Please answer the following questions that apply as accurately as possible and give examples.

Have you taken any wood shop classes?
What wood items have you made yourself?
What woodworking tools do you know how to use?
Factory positions are in constant exposure to wood dust and airborne particles. Would that be a problem for you?
Do you have any commitments that would affect your working hours?
Are you in school? If yes, please specify your major.
What are your hobbies or interests outside of work?

Authorization
By checking the "I agree to these terms" box below, you agree to the following. Please read carefully:

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure, In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between the company and me. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and that no promised or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company's designated representative.

I understand I will be required to produce a urine sample for the purpose of laboratory analysis for the presence of drugs at the time of the pre-employment physical or at some other time as designated by the company.

I further understand that if I refuse to produce a sample of urine for drug screening purposes or if I produce a urine sample which tests positive for the presence of drugs in confirmation of laboratory tests, that I will not be hired.

I understand that I have the opportunity to disclose that I have taken certain prescription drugs or over-the-counter medications which may be revealed in drug screening through urinalysis and that such information may be taken into consideration in the testing process.

I acknowledge that I have read and understand the above paragraphs relating to drug screening through urinalysis. As indicated by signature below, I hereby voluntarily consent to produce a sample of urine for the purpose of drug screening when requested to do so.

I agree to these terms Yes No

Thank you for your interest in employment at Deering Banjo Company. All applications received will be reviewed. We will contact you if we need any further information.