Employment Application

If you would like to attach your resume, please email it to: [email protected]

Personal Information

First Name

Last Name

Phone

Address

City

State

ZIP

Employment Desired

What shifts are you available for (Select all that apply)

Full-Time Part-Time Temporary Intern

How did you learn about us?

What shift(s) are you willing to work

1st 2nd 3rd Any

Date availalbe for work?

Position Applying For

Have you applied here before? If yes, give estimated date

Have you previously been employed by Pro-label?

Yes No

If yes, provide dates employed, location, and name of supervisor

Do you have relatives employed by Pro-label?

Yes No

If yes, provide name, location, and position

Have you ever used a different name or nickname?

Yes No

If yes, provide name and dates used

Are you either a U.S. Citizen or an alien authorized for work in the United States?

Yes No

Are you at least 18 years of age?

Yes No

In the last 7 years, Have you been convicted of a criminal offense other than a minor traffic violation?

Yes No

Please Explain

If applying for a position requiring driving:

Do you have a valid driver's liscense?

Yes No

Do you own or have use of a car?

Yes No

Is the car covered by automobile liability insurance?

Yes No

*NOTE: If hired for a position requiring driving a company vehicle, you will be required to submit proof of a valid driver’s license. If hired for a position requiring driving your personal vehicle for company business, you will also be required to submit proof of automobile liability insurance coverage.

List traffic violations (other than parking violations) and automobile accidents incurred during the past three years:

Education

High School

Address of High School

Years Completed

Diploma

Secondary Education

College/Trade/Business School

Course of Study

Address of School

Years Completed

Diploma/Degree

Specialized Skills

Describe any specialized training,skills, or education relevant to the position you seek:

Employment Experience

Start with your current or most recent job

Employer*

Phone

Job Title

Supervisor

Address

Dates Employed

Hourly Rate/Salary Starting & Ending

Describe your primary duties

Reason for Leaving

Employer 2

Employer

Phone

Job Title

Supervisor

Address

Dates Employed

Hourly Rate/Salary Starting & Ending

Describe your primary duties

Reason for Leaving

Employer 3

Employer

Phone

Job Title

Supervisor

Address

Dates Employed

Hourly Rate/Salary Starting & Ending

Describe your primary duties

Reason for Leaving

I certify that the foregoing information is correct and complete, and PRO-LABEL INC may terminate my employment for falsification of statements, answers or material omissions made by me in this employment application. I authorize The PRO-LABEL INC to investigate these statements, references, previous employers and school records and authorize the release of such information without liability. I understand that any job offer would be contingent upon successful completion of a pre-employment drug test and a 90 day introductory period. I further understand that employment and compensation can be terminated with or without cause at any time at the option of PRO-LABEL INC or myself.

Electronic Signature of Applicant

Date

Employment Application

Personal Information

Employment Desired

Education

Specialized Skills

Employment Experience

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