All-State Industries - Employment Application

All-State Industries Online Employment Application

Please fill in all pertinent information requested.
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Pre-Employment Physical & Drug / Alcohol Test Required

As an Equal Employment Opportunity / Affirmative Action Employer, All-State Industries is committed to complying with all applicable employment laws. All-State Industries will not discriminate against any employee or applicant for employment because of race, color, creed, religion, national origin, sex, sexual orientation, disability, age, marital status, or status with regard to public assistance.

Have you applied at All-State Industries Before?

Yes:

No:

If yes, when and what facility?

Have you worked at All-State Industries Before?

Yes:

No:

If yes, when and what facility?

Name:

First:

Middle:

Last:

Nickname:

If you ever used another name, including before or after marriage please state:

Are you under 18 years of age?

Yes:

No:

Phone Number:

Alternate phone number:

Email:

Present Address:

Street:

City:

State:

Zip:

From (month/year):

To (month/year):

Previous address in U.S.A.:

Street:

City:

State:

Zip:

From (month/year):

To (month/year):

Referred to All-State by:

List any relatives in our employ:

Date available to start work:

Do you have a legal right to work in the U.S.?

Yes:

No:

Starting wage desired:

EDUCATION

Name of last high school attended:

Street:

City:

State:

Zip:

Grade level completed:

Average grade:

Rank in class standing:

Number in class:

Special courses taken (business/vocational/etc.)

Did you graduate?

Yes:

No:

If no, please explain:

Do you plan to return?

Yes:

No:

If yes, when?

Do you have a general equivalency degree (GED)?

Yes:

No:

Location of GED Testing:

Date tested:

Courses liked:

Courses disliked:

Extra curricullar activities:

College, technical, vocational, or other institutions attended (list the most recent first).

(1) Name of school last attended:

Street:

City:

State:

Zip:

Years completed:

Average grade:

Rank in class standing:

Number in class:

Major:

Minor:

Did you graduate?

Yes:

No:

If no, please explain:

Do you plan to return?

Yes:

No:

If yes, when?

(2) Name of school last attended:

Street:

City:

State:

Zip:

Years completed:

Average grade:

Rank in class standing:

Number in class:

Major:

Minor:

Did you graduate?

Yes:

No:

If no, please explain:

Do you plan to return?

Yes:

No:

If yes, when?

PERSONAL DATA

Have you ever been convicted of a crime?

Yes:

No:

If yes, describe:

Do you have transportation to and from work?

Yes:

No:

Does your transportation allow you flexibility to work overtime before and/or after a regular shift?

Yes:

No:

Explain any limitations:

Are you willing and available to work overtime?

Yes:

No:

Explain any limitations:

Are you willing and available to work nights?

Yes:

No:

If no, please explain:

Indicate work shift preferred:

Day:

Night:

Midshift:

Other, explain:

Are you willing to relocate:

Yes:

No:

Geographical preference:

Days absent from school or work in the past 12 months:

Days absent from school or work in the previous12 months:

Do you type?

Yes:

No:

W.P.M.

K.P.M.

List any computer experience and software knowledge.

What office equipment do you operate?

What production equipment do you operate and length of time on each:

List your hobbies, special abilities and talents:

List social, educational, civic or business organizations (other than racial ethnic or religious) of which you are a member:

List volunteer work experience (other than religious or political):

Special training received in military service:

PERSONAL REFERENCES (Please list three complete references - do not list former employees or relatives)

Name1:

Relationship:

Length of time know:

Street:

City:

State:

Zip:

Phone number:

Name2:

Relationship:

Length of time know:

Street:

City:

State:

Zip:

Phone number:

Name3:

Relationship:

Length of time know:

Street:

City:

State:

Zip:

Phone number:

Employment History

List each employer, most recent employer first, include military service (If additional space is required use the comments field at the bottom of this form).

Firm Name1:

Supervisor:

Phone #:

Street:

City:

State:

Zip:

Dates (month & year)

From:

To:

Wages/comissions/bonus

Start:

Final:

Type of work:

Department:

Description of your work:

What did you like about this job?:

What did you dislike about this job?:

Reasons for leaving:

Was this job?

Full time:

Part time:

Temporary:

Number of hours per week:

Number of overtime hours per week:

Firm Name2:

Supervisor:

Phone #:

Street:

City:

State:

Zip:

Dates (month & year)

From:

To:

Wages/comissions/bonus

Start:

Final:

Type of work:

Department:

Description of your work:

What did you like about this job?:

What did you dislike about this job?:

Reasons for leaving:

Was this job?

Full time:

Part time:

Temporary:

Number of hours per week:

Number of overtime hours per week:

Firm Name3:

Supervisor:

Phone #:

Street:

City:

State:

Zip:

Dates (month & year)

From:

To:

Wages/comissions/bonus

Start:

Final:

Type of work:

Department:

Description of your work:

What did you like about this job?:

What did you dislike about this job?:

Reasons for leaving:

Was this job?

Full time:

Part time:

Temporary:

Number of hours per week:

Number of overtime hours per week:

Additional Comments: If you have any additional comments or information you feel are pertinent to this apllication please use the text box below.

PATENT / INTELLECTUAL PROPERTY AGREEMENT

In consideration of my employment, I agree that any inventions or intellectual property made by me during my employment, or within six (6) months thereafter, which result from/or are suggested by my employment with All-State Industries shall become the property of All-State Industries. If requested to do so I will apply, at the company's expense, for letters of patent or other appropriate registrations and assign to All-State Industries all rights, title and interest in such inventions or other intellectual property.

DISCLOSURE OF INVESTIGATIVE REPORT

I understand that, in processing this application, an investigation may be made in which information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted, and review of information held by law enforcement or other governmental agencies. I authorize All-State Industries to verify my past employment and education, criminal records, credit history, motor vehicle records, personal references, and other job-related data provided to All-State Industries on this application form or via the interview process. I authorize and appropriate individuals, companies, institutions, or agencies to release this information and I release them and All-State Industries from any liability as a result of such inquiries and disclosures. I have the right to make a written request, within a reasonable period of time, to recieve additional, detailed information about the nature and scope of this investigation.

I agree that any decision to hire me is contingent upon the results of my investigative report and may be conditioned upon succesful completion of a drug screen, if requested.

I understand that, if hired, I will be required to furnish proof of identity and right to workin The United States.

If hired, I agree I will serve at the will of All-State Industries and that I will be bound by the rules, policies, regulations, and terms and conditions of employment of All-State Industries as they are changed from time to time.

I understand that, if hired, I have the right, as does All-State Industries, to end my employment at any time for any reason. I also understand that false or misleading statements on this application or concealment of requested facts may be considered sufficient cause for dismissal.

You have the right to receive a copy of the investigative report from the consumer reporting agency that compiled the report. If you wish to receive a copy check here:

This form complies with The Electronic Signatures in Global and National Commerce Act of 2000 ("E-Signature Act"). Under this law, online "electronic" signatures have the same legal status as a written signature. By selecting the submit button below you agree to have furnished your signature.