| APPLICATION FOR EMPLOYMENT |
Welcome to Red Bud Industries
An Equal Opportunity Employer
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| Date:
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| Last name:
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| Middle initial:
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| First name:
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| Social Security Number:
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| Present address: |
| Street:
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| Apartment number:
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| City:
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| State:
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| Zip code:
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| Permanent address: |
| Street:
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| Apartment number:
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| City:
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| State:
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| Zip code:
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| Are you 16 years old or older?
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| Are you 18 years old or older?
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| Home phone number:
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| Cell phone number:
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| Work phone number:
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| Email Address:
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| Best time to contact you at home:
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| In case of emergency notify:
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| Address:
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| Phone number:
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| Are you prevented from lawfully becoming employed in this country because of visa or immigration status? |
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Proof of citizenship or immigration status will be required upon employment. |
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| POSITION (CHOOSE UP TO THREE) |
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Accounting |
Administrative Assistant |
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CAD |
Contract Administrator
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Customer Service |
Electrical Designer |
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Engineer-Design |
Engineer-Electrical |
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Engineer-Industrial |
Engineer-Product Safety |
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Janitor |
Machinery Builder |
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Machinist |
Maintenance |
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Material Handler |
Network Administrator |
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Office Manager |
Painter |
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Part Time Office |
Part Time Plant |
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Purchasing |
Sales |
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Saw and Drill |
Secretary |
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Service Technician |
Software Developer/Engineer |
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Stockroom |
Technical Writer |
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Welder |
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| Date you can start:
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| Salary desired:
Per:
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| Are you employed now?
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| If so may we contact your present employer?
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| Have you ever applied to this company before?
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| When?
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| Have you ever worked for this company before?
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| When?
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| Reason for leaving:
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| Name of last supervisor at this company:
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| Do any of your friends or relatives, other than spouse, work here?
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| If yes, state name & relationship:
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| Who referred you to this company: |
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Employment agency |
State employment office |
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Advertisement and where located:
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College placement service |
Walked in |
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Friend |
Other |
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| ARE YOU AVAILABLE TO WORK: |
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Full time (PLEASE INDICATE
1
2
3 SHIFT) |
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Part time (PLEASE INDICATE
MORNINGS
AFTERNOONS
EVENINGS |
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Temporary (PLEASE INDICATE DATES AVAILABLE)
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| Are you currently on "lay-off" status & subject to recall?
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| Can you travel if a job requires it?
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| EDUCATION |
GRADE SCHOOL |
| Name & location of school:
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| Numbers of years completed:
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| Did you graduate?
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HIGH SCHOOL |
| Name & location of school:
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| Numbers of years completed:
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| Did you graduate?
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| Courses of study:
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| UNDERGRADUATE / GRADUATE / OTHER (SPECIFY) |
| Name & location of school:
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| Numbers of years completed:
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| Did you graduate?
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| Courses of study:
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| ADDITIONAL INFORMATION |
| YOU MAY EXCLUDE MEMBERSHIP WHICH WOULD REVEAL GENDER, RACE, RELIGION, NATIONAL ORIGIN, AGE, ANCESTRY, DISABILITY, OR OTHER PROTECTED STATUS |
DESCRIBE ANY SPECIALIZED TRAINING, APPRENTICESHIP, SKILLS
& EXTRA-CURRICULAR ACTIVITIES: |
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| DESCRIBE ANY JOB-RELATED TRAINING RECEIVED IN THE UNITED STATES MILITARY: |
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| LIST PROFESSIONAL, TRADE, BUSINESS, OR CIVIC ACTIVITIES. |
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| OTHER QUALIFICATIONS |
| SUMMARIZE SPECIALIZED SKILLS, EQUIPMENT OPERATED, & OTHER JOB-RELATED SKILLS & QUALIFICATIONS ACQUIRED FROM EMPLOYMENT OR OTHER EXPERIENCE. STATE ANY ADDITIONAL INFORMATION YOU FEEL MAY BE HELPFUL TO US IN CONSIDERING YOUR APPLICATION. |
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| WORK EXPERIENCE |
| START WITH YOUR PRESENT OR LAST JOB. INCLUDE ANY JOB-RELATED MILITARY SERVICE ASSIGNMENTS AND VOLUNTEER ACTIVITIES. YOU MAY EXCLUDE ORGANIZATIONS WHICH INDICATE RACE, COLOR, RELIGION, GENDER, NATIONAL ORIGIN, DISABILITIES,OR OTHER PROTECTED STATUS. |
| Name & address of employer: |
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| Starting date (month/year):
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| Leaving date (month/year):
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| Weekly starting salary:
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| Weekly final salary:
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| Job title:
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| May we contact your supervisor?
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| Name & title of supervisor:
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| Phone number:
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| Description of work: |
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| Reason for leaving:
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| Name & address of previous employer: |
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| Starting date (month/year):
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| Leaving date (month/year):
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| Weekly starting salary :
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| Weekly final salary :
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| Job title :
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| May we contact your supervisor?
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| Name & title of supervisor:
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| Phone number:
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| Description of work: |
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| Reason for leaving:
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| Name & address of previous employer: |
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| Starting date (month/year):
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| Leaving date (month/year):
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| Weekly starting salary:
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| Job title:
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| May we contact your supervisor?
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| Name & title of supervisor:
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| Phone number:
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| Description of work: |
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| Reason for leaving:
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| REFERENCES |
GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU,
WHOM YOU HAVE KNOWN AT LEAST ONE YEAR. |
| Name:
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| Address:
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| Business:
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| Phone number:
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| Best time to call:
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| Years acquainted:
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| Name:
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| Address:
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| Business:
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| Phone number:
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| Best time to call:
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| Years acquainted:
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| Name:
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| Address:
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| Business:
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| Phone number:
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| Best time to call:
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| Years acquainted:
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| SERVICE RECORD |
| Branch of service:
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| Discharge date:
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| Rank:
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| Present membership in national guard or reserve:
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| Date obligation ends:
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| APPLICATION FOR EMPLOYMENT |
| This company is an Equal Opportunity/Affirmative Action Employer. We consider applicants for
all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status. In connection with your application
for employment, you may be required to take a written pre-employment test. We will provide accommodations in the testing process for disabled individuals. If you require any accommodations
in the testing process, please notify your personnel interviewer. |
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| APPLICANT STATEMENT |
It is understood and agreed the information that I have provided on this application is true
and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interview, can be justification for
refusal of employment, or, if employed, termination from the company's employment.
For employment purposes as may be necessary in arriving at an employment decision, I give the company the right to investigate all statements contained herein and the references, including past employers listed, and to secure additional information about me, whether personal or otherwise.
In connection with your application, certain positions require an investigative report which may
include a credit report, criminal record report, and a motor vehicle report. If any other report is needed, you will be notified to obtain your consent. I hereby release the company and its representatives from all liability for any damage that may result from seeking or utilization
of such information as well as all those who furnish such information.
I understand that I am subject to a urinalysis for drug testing purposes and physical examination.
The results of such examinations will be made available to the company.
This waiver does not permit the release or use of disability-related or medical information in a
manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal
and state laws.
I understand that the company is an Equal Opportunity Employer and does not discriminate
in employment and no question on this application is to be used for the purpose of limiting
or excluding any applicant's consideration for employment on a basis prohibited by local,
state, or Federal law.
I also understand and agree that no representative of the company has any authority to enter
into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company
representative.
In consideration of my employment, I agree to comply with the policies, rules, regulations, and procedures of the company which are established and maintained from time to time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee
may resign at any time and the Employer may discharge Employee at any time with or
without cause. It is further understood that this "at will" employment relationship may not
be changed by any written document or by conduct unless such change is specifically
acknowledged in writing by an authorized executive of this organization. |
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| MECHANICAL TEST |
We may ask that you take a mechanical test because our business requires high mechanical ability.
This is not an intelligence test. Low test scores do not reflect on one's personal character or
overall talent.
Thank you for applying at our company.
By checking this box, I have read and fully understand and agree with the above information. |
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Check here |
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| BACKGROUND INFORMATION |
Your background and work history will be discussed with you if you are interviewed.
Please note you are not obligated to disclose "sealed" or "expunged" records of conviction
and/or arrest.
A conviction will not automatically disqualify you for employment. Each case will be evaluated
on its facts. Please answer all the following questions with yes or no.
Have you ever been:
Placed on probation or terminated for poor job performance?
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| Disciplined or fired for insubordination?
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| Disciplined or discharged for violating a safety rule?
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Disciplined or terminated for absenteeism, tardiness, failure to notify your company when absent,
or any other attendance-related reason not relating to serious health conditions?
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| Disciplined or fired for fighting, assault, or similar offenses?
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Disciplined or discharged for being under the influence of alcohol or drugs, or for possession,
use or abuse of alcohol or drugs during the course of employment?
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| Convicted of a felony?
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By checking this box, I certify that the above answers are true to the best of my knowledge.
I understand that any falsification discovered before or after I am employed may be cause for my being disqualified or removed from employment with the company. |
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Check here |
| By submitting this information, I authorize to Red Bud Industries that I have read and fully understand & agree with the information included in this submission. |
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Red Bud Industries®
200 B & E Industrial Drive
Red Bud, Illinois 62278-2198
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| Phone: | (800) 851-4612 |
| | (618) 282-3801 |
| Fax: | (618) 282-6718 |
| | rbi@redbudindustries.com |
| EOE |
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