Career Application | Burkholder Manufacturing

Positions

Personal Information
Name*
First Middle Last
Phone
- Home
- Cell
Home*
Cell*
Your Email*
Date of birth
Date Format: MM slash DD slash YYYY
Social Security #
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Have you ever been convicted of a felony?*
- Yes
- No
State the nature of the offense, where and when it occurred and the sentence imposed.*
Employment Desired
Position desired?
How did you learn of this position?
Wage / Salary desired?
Full or part time?
Total hours available per week?
Are your hours flexible?
Are there any limitations to your work hours?
Experience

Name of previous employer	Type of business	Phone	Name of supervisor	Full or part time	Salary	Date employed from and to	Reason for leaving

High school

Name and location	Completed - yes or no

Vocational / Technical / Other

Name and location	Completed - yes or no

College

Name and location	Completed - yes or no

References

Name	Position / Company	Phone	Years acquainted

Personal Information