J&M Manufacturing - Application for Employment

J&M considers applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Availability

If Part-time or Temporary, what days or dates are you available?

Position applying for:

How did you learn about us?

Full Name

Mailing Address

City

State

Zip Code

Phone Number

Date you can start

Are you at least 18 years old?

Are currently employed?

May we contact your present employer?

Have you ever been convicted of a criminal offense?

If yes, please explain:

Have you ever been dismissed from a job?

If yes, please explain:

Education

Elementary

Name and Location

Course of Study

Years Completed

High School

Name and Location

Course of Study

Years Completed

Diploma

Graduate/Technical

Name and Location

Course of Study

Years Completed

Degree

Experience

Special Studies, apprenticeship, or training acquired from employment or other experiences:

Welding experience? With whom and how long?

Activities (Athletic, Civic, Fraternal, etc.)

Hobbies

Armed Forces

US Armed Forces

Active Duty Start Date

Active Duty Conclusion Date

List any specialized training

Employment

Current Employer

Name

City/State

Phone

Supervisor

Start Date

Start Pay

End Pay

Position/Title

Work Performed

Reason for wanting to leave

Previous Employer #1

Name

City/State

Phone

Supervisor

Start Date

End Date

Start Pay

End Pay

Position/Title

Work Performed

Reason for leaving

Previous Employer #2

Name

City/State

Phone

Supervisor

Start Date

End Date

Start Pay

End Pay

Position/Title

Work Performed

Reason for leaving

Previous Employer #3

Name

City/State

Phone

Supervisor

Start Date

End Date

Start Pay

End Pay

Position/Title

Work Performed

Reason for leaving

References

Reference #1

Name

How do you know this person?

Phone

Years Known

Reference #2

Name

How do you know this person?

Phone

Years Known

Reference #3

Name

How do you know this person?

Phone

Years Known

Emergency Contacts

Emergency Contact #1

Name

Phone

Relationship

Emergency Contact #2

Name

Phone

Relationship

Equal Employment Opportunity Applicant Information

J&M is requesting the following information to assist our equal employment opportunity efforts. This information is voluntary and will not affect the processing of your application.

Applicant Information

Position

Sex

Date of Birth

Referral Source (Ad, Friend, J&M employee, etc.)

Race/Ethnic Group

Please indicate your race/ethnic group:

White: Persons having origins in any of the original peoples of Europe or the Middle East.

Black: Persons having origins in any of the black racial groups of Africa.

Hispanic: Persons of Mexican, Puerto Rican, Cuban, Central or South American origins or other Spanish culture or origin, regardless of race.

American Indian or Alaskan Native: Persons having origins in any of the original people of North America and who maintain cultural identification through tribal affiliation or community recognition.

Asian/Pacific Islanders: Persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent or the Pacific Islands. This area includes China, Japan, Korea, the Philippine Islands and Samoa.

Disability & Veteran Status

Please check any that may apply:

Disabled: Any individual with a physical or mental impairment which substantially limits one or more of the major life activities of the individual.

Vietnam-Era Veteran: Any veteran of the armed forces who, between August 5, 1964, and May 7, 1975, served on active duty for 181 consecutive days.

Desert Storm/Shield Veteran

Disabled Veteran: Any veteran entitled to disability compensation through the Veterans Administration for a disability rated at 30% or more; or any veteran discharged or released from active duty for a disability incurred or aggravated in the line of duty.

Other Military Service, please explain:

Submission of this application affirms:

I understand and accept that, if I am selected for employment, my employment may be conditioned upon my passing any medical examination that the employer deems necessary to determine whether I can physically perform the essential functions of the position, with reasonable accommodation when necessary. I understand and accept that this may include drug, alcohol or substance abuse testing.
If employed, I understand and accept that, depending on the department in which I am applying for employment, I may be required to work evening shifts or night shifts, including weekends and be on call and work overtime hours.
I understand and accept that if any information required in this application is found to be falsified or intentionally excluded, my application may be disqualified from further consideration. If I am hired, I understand my application becomes part of my official employment record. I further understand and accept that if I am employed by the employer, I may be subject to disciplinary action, including termination, if any information required by this application has been falsified or intentionally excluded.
I hereby authorize the employers, schools and personal references named in this application to provide information regarding me to the employer. I further authorize the release of personnel, academic and other records to the employer.
I understand and accept, if employed, that I will have no reasonable expectation of privacy with respect to the use of, and/or communications made via, the Employer’s computers, telephones, etc.
I understand that a background check may be required prior to employment, and that drug testing may be required. I hereby waive all provisions of law forbidding colleges or universities which I attended, or past employers, from disclosing any information which they acquired relevant to my employment. I consent that they may disclose such information to the employer for recruitment purposes. I hereby give consent and authorize the employer to conduct, either by itself or through the utilization of an outside agency, any investigation the employer deems necessary.
In order to process your application, or during the course of your employment, a consumer report may be obtained on you for employment purposes. It may be an investigative consumer report that includes information regarding your character, general reputation, personal characteristics, and mode of living. Such report may also be necessary in relation to any investigation regarding allegations of sexual harassment, discrimination, or disciplinary charges associated with your employment. The employer may utilize an outside organization to obtain a consumer report and/or to conduct investigations. If an investigative consumer report is obtained, you have a right to request disclosure of the nature and scope of the report, which involves personal interviews with sources such as your neighbors, friends, or associates. I hereby authorize the employer to obtain a consumer report on me for employment purposes and to conduct investigations as outlined above.
I agree that any claim or lawsuit relating to my service with J&M or any of its subsidiaries must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary.

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