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Employment

Contact Information

Name (Last, First, Middle):
Address:
City:
State:
Zip:

Date of Application:
Current Telephone:
Second Telephone:
E-mail:

Position(s) of Interest

Which shifts can you work?

What is the earliest date you can start?

Personal Information

Are you at least 18 years of age? Yes No
If you are under 18 years of age, can you provide required proof of eligibility to work? Yes No
Have you ever completed an application with us before? Yes No
Do you know anyone who has, or will be working with Pickwick Manufacturing Services? Yes No
If yes, who?
Have you ever been employed with Pickwick Manufacturing Services? Yes No
If yes, give date:
Are you currently employed? Yes No
May we contact your present employer? Yes No
If yes, give employer's contact name and telephone number:
Are you currently on layoff, or furlough status and subject to call? Yes No
Are you legally entitled to work in the United States? Yes No

Education

Describe any specialized training, skills, apprenticeship, commerical driver license, job-related training received in the U.S. military and/or vocational training gained:
High School
School name and location
Years completed
9 10 11 12
College / University
School name and location
Years completed
1 2 3 4
Diploma/Degree (Yes or No, and degree named if applicable)
Yes No  
Degree:
Describe courses of study (major or emphasis)
Diploma/Degree (Yes or No, and degree named if applicable)
Yes No
Degree:
Describe courses of study (major or emphasis)

Employment History

Begin with the most recent, and include complete addresses and telephone numbers. Send us additional information if needed.
Employer 1:
Address:
City:
State:
Zip:
Name of supervisor or manager:
Telephone:
Employed (state month and year): From:    To: 
Monthly salary/hourly rate: Start: $    End: $ 
State job title and briefly describe your work:
Reason for leaving:

Employer 2:
Address:
City:
State:
Zip:
Name of supervisor or manager:
Telephone:
Employed (state month and year): From:    To: 
Monthly salary/hourly rate: Start: $    End: $ 
State job title and briefly describe your work:
Reason for leaving:

Employer 3:
Address:
City:
State:
Zip:
Name of supervisor or manager:
Telephone:
Employed (state month and year): From:    To: 
Monthly salary/hourly rate: Start: $    End: $ 
State job title and briefly describe your work:
Reason for leaving:

Employer 4:
Address:
City:
State:
Zip:
Name of supervisor or manager:
Telephone:
Employed (state month and year): From:    To: 
Monthly salary/hourly rate: Start: $    End: $ 
State job title and briefly describe your work:
Reason for leaving:

References

Please provide the name, address, and phone number of three people, who are not related to you, and whom we can contact now.
Name (Last, First, Middle):
Address:
City:
State:
Zip:
Phone:
 
Name (Last, First, Middle):
Address:
City:
State:
Zip:
Phone:
 
Name (Last, First, Middle):
Address:
City:
State:
Zip:
Phone:

Comments



It is the policy of Pickwick Manufacturing Services, to provide equal opportunity to all applicants for employment, regardless of race, color, creed, sex, age, marital status, national origin, disability, ancestry, veteran status, the presence of a non-job-related physical or mental disability or any other legally protected status, and to comply with applicable governmental regulations on this subject. The company abides by the provisions of the Civil Rights Act of 1964 and the Americans with Disabilities Act of 1990 with regard to equal employment opportunity. Candidates for a vacant position, both applicants and employees, are considered based on their qualifications to perform the essential functions of the position.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER.

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. The making of any false statements in this application will be sufficient cause for discharge.

All employment offers with Pickwick Manufacturing Services are contingent upon the passing of a pre-employment drug test, background check, and physical strength test.

Pickwick is an "at will" employer. This application is not intended to create or imply a contractual relationship. Accordingly, the right to terminate the employment relationship at will at any time is retained by both the Associate and Pickwick management.
Title of job applied for:
City: State: