Job Application

Worzalla Job Application - Manufacturing

Fill out your contact information and what job you are looking to apply for.

Educational Background

Please fill out your educational background.

Employment History

Please input your last 3 employers starting with the most recent.

Please Read and Sign Below

  • Job(s) Applying For
  • Education
  • Employment History
  • Agreement

Your Infomation

What position(s) are you applying for?

Last Name

First Name

Middle Initial

Street Address

City

State

Zip Code

Phone Number

E-mail

Are you over 18?

If not, will you be over 18 in the next 6 months?

Type of Position Applying For

Shifts Available

Salary Expected

What date will you be able to begin work?

Can you work overtime?

Are you capable of performing all of the essential job functions/tasks of the position(s) for which you are applying, with or without reasonable accommodations?

Were you previously employed by Worzalla?

If yes, when? Begin Date

End Date

Are you legally eligible for employment in the United States

Have you been convicted of a felony within the last 10 years?

If Yes, please explain. A criminal record does not constitute an automatic bar to employment and will be considered only as it relates to the job in question.

Please identify any known relative that is currently employed with Worzalla. Name and Position.

Your Skills and Aptitudes

Use the space below to describe your skills and aptitudes that you feel qualify you for position(s) for which you have applied for at Worzalla. You may wish to include civic and community activities, professional societies in which you participate, hobbies, sports, special training or skills, etc. Please do not list organizations which reveal race, religion, color, national origin, age, sex, marital status, sexual orientation, disability or any other protected status.

High School

Name of High School

Street Address

City

State

Major Studies

Minor Studies

Graduated?

GPA

Degree

College

Name of College

Street Address

City

State

Zip Code

Major Studies

Minor Studies

Graduated?

GPA

Degree

Other Education

Name of Other Education Facility

Street Address

City

State

Zip Code

Major Studies

Minor Studies

Graduated?

GPA

Type of Degree/Certification (Please specify)

Employer 1

Company

Street Address

City

State

Zip Code

Type of Business

Phone Number

Dates Employed? Beginning

End

Describe the work you did:

Hourly Starting Salary

Hourly Ending Salary

Reason for Leaving?

Name of Supervisor

Employer 2

Company

Street Address

City

State

Zip Code

Type of Business

Phone Number

Dates Employed? Beginning

End

Describe the work you did

Hourly Starting Salary

Hourly Ending Salary

Reason for Leaving

Name of Supervisor

Employer 3

Company

Street Address

City

State

Zip Code

Type of Business

Phone Number

Dates Employed? Beginning

End

Describe the work you did

Hourly Starting Salary

Hourly Ending Salary

Reason for Leaving

Name of Supervisor

Please Read and Sign Below

1. I certify that all answers given by me in this application for employment are true, accurate, and complete. I understand that falsification, misrepresentation, or omission of facts on this application, or other accompanying or required documents, including my resume, information provided in conjunction with any post-offer medical examination or drug test, or on any other company document I am required to complete if I become an employee of Worzalla, will be cause for denial of employment or immediate termination of my employment regardless of when, or how, discovered.

2. I also authorize Worzalla to contact references, past and present employers, persons, schools, law enforcement agencies and any other source of information, which may be relevant to my application of employment.

3. Further, in order that Worzalla may process my application for employment, I hereby authorize Worzalla, its subsidiaries, officers, directors, employees, representatives, and agents (hereinafter collectively referred to as "Worzalla") to conduct a complete investigation into my background including, but not limited to, inquiring into my entire employment history, including my fitness for duty at all prior employment; education history; credit history; criminal record and military records, if any; to obtain opinions and references regarding my moral character and reputation and to solicit and obtain any other information Worzalla in its sole discretion deems as necessary to determine my eligibility for employment or for the purposes of confirming the accuracy or completeness of any information I have provided to Worzalla. In consideration for the processing of my application for employment with Worzalla, I hereby RELEASE, INDEMNIFY AND HOLD HARMLESS Worzalla from any and all liability based on their authorized receipt, disclosure and use of the information gathered in processing my application for employment.

4. If requested by the management at any time, I agree to a search of my person or of any locker that my be assigned to me, and I hereby waive all claims for damages on account of such examination.

5. Although management makes every effort to accommodate individual preferences, business needs may at times make the following condition mandatory: overtime, shift work, a rotating work schedule, or a schedule other than Monday through Friday. I understand and accept these conditions of my continuing employment.

6. I understand that this is an application for employment. If employed, I agree to conform to the rules and regulations of the Company and understand that my employment and compensation can be terminated with or without cause and with or without notice at any time at the option of the Company. I may also terminate employment at any time; however, a two week written notice is required to assure payment of accrued vacation or other benefits. I further understand that no personnel recruiter or interviewer or any other representative of the Company has any authority to enter into any agreement for employment for any specified period of time and that Worzalla can change wages, benefits, and condition of employment as in their sole opinion circumstances warrant.

7. I UNDERSTAND THAT, IF HIRED, ANY OFFER OF EMPLOYMENT IS CONTINGENT UPON PRODUCTION OF PROOF OF EMPLOYMENT ELIGIBILITY AND THE COMPLETION OF FORM I-9. I FURTHER UNDERSTAND THAT ANY OFFER OF EMPLOYMENT IS CONDITIONED UPON THE RESULTS OF A DRUG TEST TO BE ARRANGED BY AND PAID FOR BY WORZALLA.

8. I further understand that this application will remain active for no more than 90 days from the date is was made. By my signature, I acknowledge that I have read and understand the foregoing and so authorize and release Worzalla.

9. I hereby certify that all the answers given by me on this form are true, accurate and complete. I understand that falsification, misrepresentation or omission of any fact on this form (or any other accompanying or required documents), will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.

I have read and understood the above.

Typing in your name constitutes a legal, binding signiture. You cannot submit your application without typing in your name.

Please Type Your Full Name

If you were referred to Worzalla by a current employee, please input the full name of the employee