Career Application | Burkholder Manufacturing

Personal Information

Name*

First Middle Last

Phone

Home
Cell

Home*

Cell*

Your Email*

Date of birth

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

Skills - Indicate if you have experience in any of these jobs and how much.

Sales

Welding & metal working

Mechanical (Repair etc.)

Other

Education

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

Other details

Name

This field is for validation purposes and should be left unchanged.