Name *

First Name

Last Name

Phone *

(###)

###

####

Present Address *

Number, Street, City, State & Zip

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth *

MM

DD

YYYY

Days Available to Work

Monday

Tuesday

Wednesday

Thursday

Friday

Employment Desired

Full-Time Only

Part-Time Only

Full- OR Part-Time

High School (Location)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

College (Location)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business or Trade School (Location)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

From

MM

DD

YYYY

To

MM

DD

YYYY

From

MM

DD

YYYY

To

MM

DD

YYYY

From

MM

DD

YYYY

To

MM

DD

YYYY

Are you currently employed?

Yes

No

May we contact your present employer?

Yes

No

Have you ever been convicted of a felony?

Yes

No

Are you now a member of the National Guard?

Yes

No

If hired, can you provide proof of U.S. citizenship or proof of your legal right to live and work in this country?

Yes

No

If hired, would you have a reliable means of transportation to and from work?

Yes

No

Are you able to perform the essential functions and duties of the job for which you are applying?

Yes

No

Reference 1

First Name

Last Name

Phone (Reference 1)

(###)

###

####

Reference 2

First Name

Last Name

Phone (Reference 2)

(###)

###

####

Reference 3

First Name

Last Name

Phone (Reference 3)

(###)

###

####

Checkbox *

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the submitting applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or any other document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. I hereby authorize TDP Automation & Design and KRAL'S Welding & Fabrication to investigate my references and work records. I further authorize the employers, schools and other references I have listed to disclose to TDP & KRAL'S any and all documents, transcripts, letters, reports and other information related to these references, without giving me prior notice of such disclosure. I understand that nothing contained in the application, or conveyed during any interview which may be granted, or during my employment, if hired, is intended to create an employment contract between me and TDP & KRAL'S, other than one that is "at will." I understand and agree that if I am employed, my employment will be of an "at will" nature, whereby either the employee or the employer may terminate the employment relationship at any time, with or without cause or notice. I further understand that my employment, if hired, is for no definite or determinable period of time and may be terminated at any time, at the option of either myself or TDP & KRAL'S, and that no promise or representation contrary to the foregoing is binding on the company unless made in writing and signed by me and the company's designated representative. TDP & KRAL'S is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment depends solely on your qualifications.

I have read and agree to the waiver explained above.