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General
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If employed and under 18, can you furnish a work permit?:
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Have you ever been employed by this company?:
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Are you employed now?:
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May we contact your present employer? :
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Are you prevented from lawfully becoming employed in this country because of visa or immigration status?:
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Do you have a valid driver's license?:
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Can you perform the essential functions of the job(s) for which you are applying?:
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Are you available to work:
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Have you been convicted of a felony?:
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Accepted Formats: PDFs
Education
Level of education completed:
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Special Skills, Qualifications and Considerations

Summarize special skills and qualifications, volunteer activities, military experience, employment or other activities related to the job you are seeking.

References

List three (3) non-relatives who are familiar with your qualifications, work history, and ability.



Employment Experience

Employer 1

 Start (mo-year) to End (mo/yr or present) Example: 02/15 to 10/17
 Example: $25,000/yr to $35,000/yr or $11.00/hr to $14.00/hr

Employer 2

 Start (mo-year) to End (mo/yr or present) Example: 02/15 to 10/17
 Example: $25,000/yr to $35,000/yr or $11.00/hr to $14.00/hr

Employer 3

 Start (mo-year) to End (mo/yr or present) Example: 02/15 to 10/17
 Example: $25,000/yr to $35,000/yr or $11.00/hr to $14.00/hr

Employer 4

 Start (mo-year) to End (mo/yr or present) Example: 02/15 to 10/17
 Example: $25,000/yr to $35,000/yr or $11.00/hr to $14.00/hr

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK BEFORE SIGNING.

I certify that all answers and statements I have made on this application (and resume or other supplementary materials) are true and complete without omissions. By signing below, I authorize Iowa Rotocast Plastics, Inc. to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I understand that any false information provided by me will likely result in a refusal to hire or immediate discharge if I am employed. I authorize any of the persons or organizations named in this application to give you complete information and records regarding my employment, education, character and qualifications.

If hired I will be responsible for familiarizing myself with all rules and regulations of Iowa Rotocast Plastics, Inc. as they presently exist or are later modified. If hired, I understand my employment can be terminated, at the discretion of Iowa Rotocast Plastics, Inc. or at my option, without notice, at any time and for any reason.

I also understand that no representative of Iowa Rotocast Plastics, Inc. has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the president of Iowa Rotocast Plastics, Inc.

I understand this application is not an offer of employment and no promises or representations of employment have been made to me at this time.

Terms of agreement:
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