Apply Online Step 1 of 4 25% Application For EmploymentWe are pleased that you have decided to apply for a job with us. It is our policy to not to discriminate against any employee or applicant for employment because of race, color, religion, sex or national origin, disability, handicap or veteran status. We take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, national origin, disability, handicap or veteran status. Such action shall include, but not be limited to the following: employment, upgrading, demotion, or transfer, recruitment advertising, layoff or termination, rate of pay or other forms of compensation, and selection for training, including apprenticeship. Please fill out the application thoroughly and accurately, since misrepresentation or omission of facts may be grounds for dismissal after employment. The Company will verify the statements on this application. All applicants should complete the following and authorize consent in all three (3) places for application to be accepted. This application is effective for only a 45 day period, after which time if you still wish to be considered for employment, you will need to fill out another application. Name* First Last Other names by which you are knownAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone*Social Security Number*Are you under 18 years of age?*YesNoReferred by:Any relatives/people you know who work here?Are you a US citizen?*YesNoIf NO, explain:*If not a US citizen, are you legally authorized to work in the USA?*YesNoDo you intend to work at another job or attend school while working here?*YesNoIf YES, explain:*Can you work overtime as the Company requires?*YesNoIf applying for factory job, can you work any shift?*YesNoDo you have transportation to and from work?*YesNoPosition applying for:*Date Date Format: MM slash DD slash YYYY List any skills, knowledge or education that may be of use to the Company:Have you previously worked at Protech Metal Finishing?*YesNoIf yes, when?* School RecordGrade SchoolDegree/Certificate:Name of School:Address and City:Course of Study:High SchoolDegree/Certificate:Name of School:Address and City:Course of Study:College/ Trade SchoolDegree/Certificate:Name of School:Address and City:Course of Study:Consent* I AgreeI authorize the above schools to release any information requested by the Company. Work ExperiencePast EmployersDatesName of EmployerAddress and PhoneSupervisorYour JobWageReason for Leaving Consent* I AgreeI authorize the above employers to release any and all information requested by the Company: Applicant's UnderstandingPersonnel Policies I understand in the event I am employed by the Company to whom I am making this application that any of the Company’s employee handbooks, personnel policies, hours of work, employee rules, insurance benefits, employee benefits or other conditions of employment are not intended to be legally binding and are not a promise for continued employment. I agree they can be changed or eliminated at any time by the Company without notice except as required by statutory law. I understand the Company may follow disciplinary procedures that it decides are appropriate with me and these procedures may not be the same each time I am disciplined and the Company may not follow the same procedure with all employees. Employment at Will I understand I remain free to resign my employment at any time, for any reason, without notice. Similarly, the Company retains the right to terminate my employment at any time, for any or no reason, without notice. No one but the President of the Company has the authority to change this, and he/she may do so only in writing. Any statements to the contrary by anyone else are unauthorized, expressly disallowed, and should not be relied upon by anyone. Drug Testing I understand the Company maintains a Drug-Free Workplace and that I may be tested for illegal drugs before hire as part of my application for employment. I also agree to be tested for illegal drugs by the Company at random at any time during my employment and that the Company may terminate my employment if such tests are positive for illegal drugs. I also understand I may be tested for illegal drugs and/or alcohol as outlined in the Company’s Drug-Free Workplace Policy. Truthfulness in This Application I hereby certify my answers herein are true and correct and further understand that any information withheld or falsely provided by me and/or regarding my Application for Employment will subject me to immediate termination of employment at any time in the future. Release of Non-Medical Information I authorize any persons, employers, institutions, or federal, state, county, municipal or other governmental Agencies to release any past non-medical records or information about me requested by the Company to whom I am making this application, or its representative, and any future non-medical records or information after hire by the Company. I believe information concerning my performance as an employee as well as any other information requested by the Company or its representative will assist me in obtaining employment with the Company. Therefore, in consideration for the Company’s act of considering me for employment, I hereby agree to release and hold harmless the Company or its representatives and any past employer or other persons, for all liability in any way related to the investigation of my suitability for employment with the Company. Moreover, I specifically authorize any person (natural or otherwise) to make full response to any inquiry in connection with my Application for Employment with the Company. Release of Medical Information If hired by the Company, I will sign a release that authorizes any persons, employers, medical facilities, institutions, insurance companies or federal, state, county, municipal or other governmental agencies to release any past medical records or other information about me requested by the Company to whom I am making this application, or its representative, and any future medical records or information at any time after hire by the Company. Authorization Copy I instruct all recipients of this authorization that a copy is as valid as the original at any date in the future.Consent* I AgreeI acknowledge that you have read the above, agree to its provisions and authorize releases.NameThis field is for validation purposes and should be left unchanged.