Careers - Fluid Power Support

General Information

Name (Last)

(First)

(Middle Initial)

Social Security No.

Required Format: xxx-xx-xxxx

Address (Mailing Address) *

(City) *

(State) *

(Zip) *

Home Telephone

Required Format: xxx-xxx-xxxx

Cell Phone *

Required Format: xxx-xxx-xxxx

Email Address

Are you legally entitled to work in the U.S.? *

Yes

No

Position

Position or Type of Employment Desired

Referred By

Are you currently employed? *

Yes

No

Date Available *

Salary Desired *

Have you ever applied for employment with us? *

Yes

No

If yes, Month and Year

Are you able to perform the essential functions of the job you are applying for, with or without reasonable accommodations?

Yes

No

If no, please explain

Have you ever been convicted of a felony? *

Yes

No

If yes, please explain

Note: A conviction record will not necessarily disqualify an applicant from employment. The circumstances of the conviction will be considered in relation to the nature and duties of the job applied for.

Education and Training

High School

Name & Location

Dates Attended

From - To

Graduated?

Yes

No

Degree

College

Name & Location

Dates Attended

From - To

Graduated?

Yes

No

Degree

Other

Name & Location

Dates Attended

From - To

Graduated?

Yes

No

Degree

Occupational License, Certificate or Registration

Number

Where Issued

Expiration Date

Occupational License, Certificate or Registration

Number

Where Issued

Expiration Date

Military

Are you a veteran?

Yes

No

Branch of Service

Date of Entry

Date of Discharge

Employment History

Employer *

Phone

Address

Job Title *

Number of Employees Supervised

From *

Month/Year

To *

Month/Year

Hours Per Week

Last Salary

Specific Duties *

Supervisor

May We Contact This Employer? *

Yes

No

Reason for Leaving

Employer

Phone

Address

Job Title

Number of Employees Supervised

From

Month/Year

To

Month/Year

Hours Per Week

Last Salary

Specific Duties

Supervisor

May We Contact This Employer?

Yes

No

Reason for Leaving

Employer

Phone

Address

Job Title

Number of Employees Supervised

From

Month/Year

To

Month/Year

Hours Per Week

Last Salary

Specific Duties

Supervisor

May We Contact This Employer?

Yes

No

Reason for Leaving

References (non-relatives ONLY)

Full Name *

Relationship *

Company *

Phone *

Address *

Full Name *

Relationship *

Company *

Phone *

Address *

Full Name *

Relationship *

Company *

Phone *

Address *

As part of our procedure for processing your employment application, your employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You give permission for Fluid Power Support LLC. to obtain reference information from your former employers, schools, and other agencies. I hereby release Fluid Power Support LLC., my former employers, and all other persons, corporations, partnerships, and associates from any and all claims or liabilities arising out of or in any way related to such investigation disclosure. If necessary, for employment you may be required have a physical examination and/or a drug test, or to sign a conflict-of-interest agreement and abide by its terms. I understand and agree to the information show above.

Signature of Applicant

Date

After submission of this form, you will be taken to a page where you can upload your resume. Thank you for your application!