At Croc Line

First Name *

Last Name *

Address *

City *

State *

ZIP Code *

Email *

Home Phone

Cell Phone *

Position Interested In *

Type of employment desired *
Full-TimePart-TimeTemporary

Start Date *

If you have been laid off, are you subject to recall? *
YesNo

Do you have any objection to working overtime if necessary? *
YesNo

Can you travel if required by this position? *
YesNo

Have you ever been previously employed by our organization? *
YesNo

Can you submit proof of legal employment authorization and identity? *
YesNo

Have you ever been convicted of a crime (felony/misdemeanor)? *
YesNo(A conviction will not necessarily disqualify you from employment)

Who should we thank for referring you to us?

Employment History

Provide the previous four employers, even if including a resume. Start with the most recent.

Summarize any job-related training, skills, licenses, certificates, and/or other qualification

Additional Experience and Skills

Add the years of experience in the space to the right of the field listed below, check all that may apply:

Adm. Assistant

AP Clerk

Band Saw Operator

Blaster

BOM Analyst

CNC Machinist

CS & Spare Parts Lead

Design Engineer

Electric Drafter

Fabrication Manager

Field Services Technician

Heavy Equip Operator

HR Manager

Hydraulic Lead

Inside Sales

Inventory Clerk

Janitor Bldg Services Tech

Laser Jet Operator

Logistics Coordinator

Machinist/Manual

Management

Mechanic - Chassis

Mechanic - Electrical

Mechanic - Plumbing

Mechanical Designer

Media Specialist

Operations Manager

Outside Sales - International

Painter

Press Brake

Project Manager

Purchasing

Quality Control

Sales

Sales & Mktg Support Mgr.

Sandblaster

Shipping Clerk

Shop Floor Coord.

Shop Helper

Technician

Training

Transponder

Video Prod. Director

Videographer

Water Jet Operator

Web Designer

Welder

Welder/Fabricator

Educational History

Professional References

Include those you have worked for or with. Do not include family or friends.

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

Type name as signature *

Date *