Job Application

Title: OUTSIDE SALES/PRODUCT TECH

Fields marked with an asterisk (*) must be filled out before submitting.

Personal Information
Phone Number *
Email Address *
First *
Middle *
Last *
Social Security Number *
Address
Street *
City *
State *
Zip Code *
Available Start Date
Select a Date *
Salary Required
Schedule you are willing to work? *
Have you ever worked for us before? * Yes

No
Are you legally authorized to work in the United States? * Yes

No
Work History – Most Recent First
Present or Last Position
Name of Company
Number of Years Worked
Date you Left
Reason for Leaving
Position
Name of Company
Number of Years Worked
Date You Left
Reason For Leaving
Position
Name of Company
Number of Years Worked
Date you Left
Reason for Leaving
Position
Name of Company
Number of Years Worked
Date you Left
Reason for Leaving
Education Information
High School or GED
Address/City/State
Degree Yes

No
College
Addess/City/State
Degree Yes

No
Graduate School
Address/City/State
Degree Yes

No
Other
Address/City/State
Degree Yes

No
General
Special Skills or Experience (machines, forklift, tools, read blue prints, etc.)
If applying for an office position, what business equipment can you operate? (For example, computers, copiers, etc.)
In what computer software programs are you proficient? (Name the package(s).)
Please Read the Following Statements Carefully
Notice to Applicants:
Ace Manufacturing & Parts Company and Rokwell Industries welcome all qualified applicants without regard to their race, color, religion, gender, national origin, age, marital status, disability or other protected status. Please complete the application completely. Information provided will assist with the evaluation of your qualifications. All offers of employment are contingent upon successful completion of required post offer examinations including, but not limited to, drug screen, physical, criminal background check. Employment with Ace Mfg. & Parts Co. /Rokwell Industries is employment “at will”. This application and/or other human resources related forms provided to you do not constitute and employment contract.
Check here to acknowledge you have read the statement above. * I acknowledge
In consideration of my employment, I agree to conform to the policies and procedures of the company. I understand that in accepting this application, the company is in no way obligated to provide me with employment and that I am not obligated to accept employment if offered. Furthermore, if employed, I understand that I am employed at will and that my employment and compensation can be terminated with or without cause, and with or without notice at any time.
Check here to agree to the above Statement * I agree
I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any falsified statements on this application or omission of the fact on either this application or during the pre-employment process will result in my application being rejected, or, if I am hired, in my employment being terminated.
Check here to agree to the above Statement * I agree
I also understand that any offer of employement is contingent on successfully passing a physical exam and drug screen and pre-employment testing. I agree to refund the Company the cost of my physical exam and drug screen, if I fail to pass the drug screening, fail to report to work or resign or am terminated for any reason during the 90-calendar day probation period. I authorize a payroll deduction of that amount from my final paycheck.
Check here to agree to the above Statement * I agree
I authorize the company and/or its agents, including consumer reporting bureaus, to verify any of this information, including criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law enforcement authorities to release any information concerning my work and educational record and background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for releasing this information. I also understand that the use of illegal drugs is prohibited during employment.
Check here to agree to the above Statement * I agree
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