BRAND HYDRAULICS - Job Opportunities

Application for Employment

* = Required Fields


*Date of Application:	00/00/0000
*Position Applied for:

*Name:

* Social Security #:

000-00-0000

*Address:

*City:

*State: *Zip:

*Telephone/Cell/Pager #s:

*Email Address:

*Best time to call you at home is:

*May we contact you at work?

If yes, work number: and best time to call:

*If you are under 18 and it is required, can you furnish a work permit?

If no, please explain:

*Have you submitted an application here before?

If yes, give date(s) and positions(s):

*Have you ever been employed here before?

If yes, give dates "from" and "to":

*Are you legally eligible for employment in this country?

*Date available for work: 00/00/0000

*Desired salary range or hourly rate of pay:

*Type of employment desired: (Check all that apply)
       Full Time
       Part Time
       Temporary

*Type of work schedule interested in: (Check all that apply)
       Days
       Nights
       Weekends
       Overtime

*Will you relocate if job requires it?

*Will you travel if job requires it?

*Are you able to meet this work schedule?

*Will you work overtime if required?

If no, please explain:

Driver’s license number required if driving may be required in the job for which you are applying: State:

*Have you ever been bonded?

Answering "yes" to the following question does not constitute an automatic bar to employment. Factors such as date of the offense,
seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

*Have you ever pled "guilty" or "no contest" to, or been convicted of a crime?

If yes, please provide dates and details:

Employment History

Starting with your most recent employer, provide the following information:

*Employer #1:

*Address:

*City:

*State:

*Zip:

*Phone:

*Dates Employed:

to:

*Starting Job Title:

*Final Job Title:

*Immediate supervisor and title:

*May we contact for a reference?

*Starting Pay:	Hourly	Salary			per
*Final Pay:	Hourly	Salary			per

*Why did you leave?

*Summarize the type of work performed and job responsibilities:

*What did you like the most about your position?

*What did you like the least about your position?

Employer #2:

Address:

City:

State:

Zip:

Phone:

Dates Employed:

to:

Starting Job Title:

Final Job Title:

Immediate supervisor and title:

May we contact for a reference?

Starting Pay:	Hourly	Salary			per
Final Pay:	Hourly	Salary			per

Why did you leave?

Summarize the type of work performed and job responsibilities:

What did you like the most about your position?

What did you like the least about your position?

Employer #3:

Address:

City:

State:

Zip:

Phone:

Dates Employed:

to:

Starting Job Title:

Final Job Title:

Immediate supervisor and title:

May we contact for a reference?

Starting Pay:	Hourly	Salary			per
Final Pay:	Hourly	Salary			per

Why did you leave?

Summarize the type of work performed and job responsibilities:

What did you like the most about your position?

What did you like the least about your position?

Skills and Qualifications

*Please list any skills you possess and/or equipment you are qualified to operate:

Educational Background

Start with your most recent school attended, provide the following information:

	School:	Years Completed:	GPA:	Major/Minor:
*1.
2.
3.
4.

References

List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.

	Name:	Title:	Relationship to you:	Phone:	Number of years known:
*1.
*2.
*3.

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct.

I authorize the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume’ or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations for furnishing such information about me.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I further understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer’s service, whenever it is discovered.

DO NOT ENTER YOUR NAME UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement:

*Name:

*Date:

00/00/0000

CONTACT:

Brand Hydraulics
Attn: Human Resources
2332 S. 25th Street
Omaha, NE 68105
Phone: 402 344-4434
Fax: 402 344-8091
Or email: ebianchi@brand-hyd.com

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