The Plastek Group – Job Application

Please fill out all information

PLEASE PRINT

Please leave this field empty. Position(s) applied for ^*

Application Date

Month*

Day*

Year*

Name:

Last Name ^*

First Name ^*

Middle Name

Social Security # ^*

Address:

Street Address ^*

City ^*

State ^*

ZIP Code ^*

Area Code ^*

Phone Number ^*

Area Code

Additional Phone Number

E-mail Address ^*

Type of employment desired:

Full-Time Part-Time Temporary

Seasonal Educational Co-Op

Date of Availability

Month ^*

Day ^*

Year ^*

What is your desired salary range? ^*

Have you ever been employed here before?

Yes No

If yes, give dates and positions

Are you able to meet the attendance requirements of the position? ^*

Yes No

Are you legally eligible for employment in the United States? ^*

Yes No

Have you ever pled “guilty” or “no contest” to, or been convicted of a crime?

Yes No

Answering “yes” to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

If yes, please explain the nature of the offense, date, and any rehabilitation efforts

Driver’s license number if driving is an essential job function

State

If you are under 18, can you furnish a work permit?

Yes No

Employment History

Provide the following information of your past four (4) employers, assignments or volunteer activities, starting with the most recent.

Employer 1

From

Employer

Area Code ^*

Phone Number ^*

Starting/Final Job Title ^*

Address ^*

Immediate Supervisor and Title ^*

Summarize the nature of work performed and job responsibilities ^*

May we contact for reference?

Yes No Later

Reason for leaving ^*

Hourly Rate/Salary ^*

Employer 2

From

Employer

Area Code

Phone Number

Starting/Final Job Title

Address

Immediate Supervisor and Title

Summarize the nature of work performed and job responsibilities

May we contact for reference?

Yes No Later

Reason for leaving

Hourly Rate/Salary

Employer 3

From

Employer

Area Code

Phone Number

Starting/Final Job Title

Address

Immediate Supervisor and Title

Summarize the nature of work performed and job responsibilities

May we contact for reference?

Yes No Later

Reason for leaving

Hourly Rate/Salary

Employer 4

From

Employer

Area Code

Phone Number

Starting/Final Job Title

Address

Immediate Supervisor and Title

Summarize the nature of work performed and job responsibilities

May we contact for reference?

Yes No Later

Reason for leaving

Hourly Rate/Salary

Skills and Qualifications

Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job related functions in the position for which you are applying.

Skills and Qualifications ^*

Educational Background

High School

(Name and Location) ^*

Number of Years Completed

Did You Graduate?

Course of Study

College

College (Name and Location)

Number of Years Completed

Major

Degree

Technical Training

Technical Training (Name and Location)

Number of Years Completed

Major

Degree

Other

Other (Name and Location)

Number of Years Completed

Major

Degree

References

Reference 1

Name ^*

Area Code ^*

Phone Number ^*

Number of Years Known ^*

Reference 2

Name

Area Code

Phone Number

Number of Years Known

Reference 3

Name

Area Code

Phone Number

Number of Years Known

Applicant Statement

Do you consider yourself capable of performing all of the essential functions of the job(s) for which you are applying? ^*

Yes No

Accommodation ^*

I certify that all information I have provided in order to apply for and secure work with the employer is true complete and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer’s service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I haven’t heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Signature of Applicant ^*

Application Date

Month ^*

Day ^*

Year ^*

Choose Plastek for All Your Plastic Manufacturing Needs

With locations in the United States, the United Kingdom, Brazil, and Mexico, we have grown to become a world class leader in plastic manufacturing for the Personal Care, Beauty, Home Care, Pharmaceutical, and Food and Beverage Packaging Industries. We specialize in Industrial Design, Product and Package Development, Injection, Injection Blow, and Injection Stretch Blow Molding as well as value added Assembly and Decorating.

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