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Employment Application

Background Information:

Job Interest:

Are you willing to travel overnight?

Are you able to perform the essential functions of the job for which you are applying with or without accommodation?

Our company is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, national origin, ancestry, sex, age, handicap, veteran’s status and sexual orientation.


Work Experience:

Are you currently on "lay-off" status and subject to recall?

Have you ever been involuntarily terminated from employment? • If "yes," please explain:

If presently employed, may we contact your employer as a reference?

Please list work experience for at least the past five years beginning with the most recent job held:

Personal/Professional Reference:



Are you a citizen of the United States?

If not, do you have legal authorization to perform work in the United States?

Are you at least 21 years of age?

Do you possess a valid Wisconsin driver's license?

Have you ever been convicted of a crime other than a minor traffic violation?

Do you have any pending arrests?

Have you ever been convicted of a felony?

Please read the following statements carefully, they constitute the conditions under which you would be employed by the Company should you be accepted for employment.

I certify that all information that I have provided on this application is true and complete to the best of my knowledge.  I understand that falsification; misrepresentations or omission of facts called for in this application may result in denial of employment or immediate dismissal.

I understand that if the Company employs me, my employment is for no definite term and that I can be terminated at any time without notice and without cause.  I further understand that no verbal promises or guarantees are binding on the Company and that no one, other than the President of the Company, has authority to enter into an agreement for employment contrary to the above, and that any such agreement must be in writing.  If employed, I agree to abide by all of the Company’s rules and regulations, and any changes thereto.  I give the Company permission to investigate all pertinent information concerning my application in order to determine my qualifications for employment.  I understand that any offer of employment may be rescinded if the results of the investigation are unacceptable to the Company.