Bailey Metal Fabricators Inc

About Us
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Date:

Personal Information

Name:

Social Security #:

Address:

City:

State:

Zip:

City:

State:

Zip:

Home Phone Number:

Work Number:

Position Desired:

Regular Occupation:

When Will You Be Available For Work?

Are You 18?:

Yes:

No:

Are You Applying For:

Full Time:

Temporary:

Seasonal:

Part Time:

If applying for Seasonal or Part time, specify days and hours:

Will You Work Overtime?

Yes:

No:

Will You Work Saturdays?

Yes:

No:

State Any Limitations On Working Hours:

How Were You Referred To Us?

Job Service:

Ad:

Walk-In:

Other:

Are you eligible for employment in the U.S.?

Yes:

No:

Have you ever been convicted of a felony?

Yes:

No:

If "yes", Please Give Details. Convictions
Will Not Necessarily Disqualify
For Employment:

Will you abide by the rules set forth by the company?

Yes:

No:

Certifications / Specialized Training

Please list any certifications / or specialized training that you have had.

Type of Certification / Training:	Place:	Dates:

Comments:

Driver Information

To be completed by anyone who will drive employer's vehicle whether regularly or occasionally.

Type Of Drivers License You Hold :

Operator:

Commercial:

Chauffer:

What State?:

How Many Years Have You Been Driving?

Less Than 1 Year:

2-3 Years:

Over 3 Years:

Has your Driver's License been revoked or suspended in the last 3 years?

Yes:

No:

If, "Yes", Explain:

Did you have any moving violations or accidents in the last 3 years?

Yes:

No:

If "Yes", List Below:

Month / Year:	Violations (not parking)	Month / Year:	Description of Accident:

Employment History

Give complete full-time and part-time employment record. Start with your present or most recent employer.

Employer #1

Company Name:

Telephone:

Address:

City:

State:

Zip:

Name Of Supervisor:

Dates Employed:
(Month & Year)

Job Title:

Pay Start:

Duties:

Reason For Leaving:

Employer #2

Company Name:

Telephone:

Address:

City:

State:

Zip:

Name Of Supervisor:

Dates Employed:
(Month & Year)

Job Title:

Pay Start:

Duties:

Reason For Leaving:

Employer #3

Company Name:

Telephone:

Address:

City:

State:

Zip:

Name Of Supervisor:

Dates Employed:
(Month & Year)

Job Title:

Pay Start:

Duties:

Reason For Leaving:

Employer #4

Company Name:

Telephone:

Address:

City:

State:

Zip:

Name Of Supervisor:

Dates Employed:
(Month & Year)

Job Title:

Pay Start:

Duties:

Reason For Leaving:

Skills

Indicate work experience with the following: (List length of time also. Example - 6 months, 1 year, etc)

Office Equipment:		Other Office Machines; Please List:
	10 Key Calculator
	Typing
	Data Entry
	Accounting
	Computers

Comments:

Other: (List length of time also. Example - 6 months, 1 year, etc)
	Wire Feed Welding	Mill
	Stick Arc Welding	Lathe
	Tig Welding	Drill Press
	Steel Welding	Painting System
	Aluminum Welding	Press Brake
	Stainless Welding	Shear
	Overhead Cranes	CNC Systems
	Forklift	CAD Systems

List other experience, skill or qualifications which you feel
would especially fit you for the position applying for:

Additional
Experiences:

We may contact employers listed previously unless you indicate those you do not want us to contact.

DO NOT CONTACT:		Employer Telephone:
		Reason:
DO NOT CONTACT:		Employer Telephone:
		Reason:

Education

School	Name/Location	Area of Study	No. Yrs	Graduate	Degree/Diploma
Elementary
High School
Trade School
College
Graduate

I, understand that this application is not, and is not intended to be a contract of employment,
and that employment may be terminated at any time with or without cause
and with or without notice, by either party.

Signature:

Date:

Your application will be considered for 60 days from the date of application.
If you wish it to be renewed, you must reapply.

CALL FOR A FREE ESTIMATE • 605.996.4306 • MITCHELL, SOUTH DAKOTA