GENERAL INFORMATION

Name:
Last   
First   
Middle

Present Address:

City: State: AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY

Zip: Telephone:

Cell Phone:

E-Mail Address:

Fax:

Social Security #:

Have you filed an application of employment here before? Yes No

Are you over 18 years of age? Yes No
If no, give date of birth:

Are you legally authorized to work in the United States? Yes No

Have you ever been convicted of any felonies within the past seven (7) years? Yes No (A conviction will not necessarily disqualify you from employment with United Sheet Metal. You need not disclose information relating to sealed or expunged records.)

If yes, list felony conviction(s) and date(s) of conviction(s):

For reference checking, list all names that you have used in the past.

Position Applied for:

Date Available:

Are there any restrictions on the hours or day you are able to work? Yes No

If so, when are you available to work?

EMPLOYMENT HISTORY

List all work experience within the last five (5) years and all applicable experience prior to that (include U.S. Military Service and periods of unemployment). If there were periods when you were self-employed or unemployed, list name and address of person(s) (not a relative) who can verify. If additional space is required, attach an extra sheet, including the information specified below.

Company Name:

Date Started:

Date Left:

Starting Position:

Company Address:

Last Position:

Starting Salary:

Ending Salary:

Supervisor's Name and Telephone Number:

Specific Duties:

Reason for Leaving:

Company Name:

Date Started:

Date Left:

Starting Position:

Company Address:

Last Position:

Starting Salary:

Ending Salary:

Supervisor's Name and Telephone Number:

Specific Duties:

Reason for Leaving:

Company Name:

Date Started:

Date Left:

Starting Position:

Company Address:

Last Position:

Starting Salary:

Ending Salary:

Supervisor's Name and Telephone Number:

Specific Duties:

Reason for Leaving:

Company Name:

Date Started:

Date Left:

Starting Position:

Company Address:

Last Position:

Starting Salary:

Ending Salary:

Supervisor's Name and Telephone Number:

Specific Duties:

Reason for Leaving:

Company Name:

Date Started:

Date Left:

Starting Position:

Company Address:

Last Position:

Starting Salary:

Ending Salary:

Supervisor's Name and Telephone Number:

Specific Duties:

Reason for Leaving:

Check box if you do NOT want us to contact your present employer:

Reasons:

EDUCATIONAL HISTORY

GED
Name of School: Location:

Type of Degree, Diploma or Certificate:

If did not graduate, state why:

HIGH SCHOOL
Name of School: Location:

Type of Degree, Diploma or Certificate:
Grade Completed: 9 10 11 12

If did not graduate, state why:

COLLEGE/UNIVERSITY
Name of School: Location:

Type of Degree, Diploma or Certificate:
Years Completed: 1 2 3 4

If did not graduate, state why:

GRADUATE SCHOOL
Name of School: Location:

Type of Degree, Diploma or Certificate:
Years Completed: 5 6 7 8

If did not graduate, state why:

List other education or training, if any.

List current professional licenses, registration and certificates, if any.

PERSONAL REFERNCES (other than relatives or former employers listed above)

Name: Address:

Telephone: Work Phone:

Occupation: Years Known:

Name: Address:

Telephone: Work Phone:

Occupation: Years Known:

Name: Address:

Telephone: Work Phone:

Occupation: Years Known:

THIS APPLICATION FOR EMPLOYMENT IS GOOD FOR 30 DAYS ONLY.

CONSIDERATION FOR EMPLOYMENT AFTER 30 DAYS REQUIRES A NEW APPLICATION.

PLEASE READ THE FOLLOWING CAREFULLY AND SIGN WHERE APPLICABLE

APPLICANT'S UNDERSTANDING AND ACKNOWLEDGEMENT

The information that I have provided to United Sheet Metal, Inc. is accurate to the best of my knowledge and subject to validation by United Sheet Metal, Inc. I understand and agree that any misrepresentation or omission of fact in my application may be justification for not being hired or, if hired, termination of any employment with United Sheet Metal, Inc.

I understand that an offer of employment and my continued employment with United Sheet Metal, Inc. are contingent upon satisfactory proof of my authorization to work in the United States. I understand that nothing contained in this employment application, in the granting of any interview, or in any United Sheet Metal, Inc. policies, procedures, correspondence or handbooks that I might receive is intended to create an employment contract between myself and United Sheet Metal, Inc. for either employment or for the providing of any benefit. No promises regarding continued employment have been made to me, and I understand that no such promise or guarantee is binding upon United Sheet Metal, Inc. unless made in writing. I understand that, if hired, my employment is terminable at-will, and that either I or my employer may terminate my employment at any time, with or without cause, for any or no reason, and that I am not being employed for an specific term.

I authorize a thorough investigation of my educational and professional background, past employment and activities that may relate in any way to my qualifications for employment with United Sheet Metal, Inc.

I authorize schools and prior employers to provide any information they have concerning me to United Sheet Metal, Inc. and I hereby hold harmless United Sheet Metal, Inc. and all those providing information about me to United Sheet Metal., Inc. from any liability that may arise out of or result from the provision or use of such information.

UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.

I have read and understand the above statements.

Applicant Signature:

Date: