Full Employment Application Please enable JavaScript in your browser to complete this form. Employment Application for Matthews Plating Matthews Plating, INC.405 N. Mechanic St. Jackson, MI. 49201 It is the policy of Matthews Plating to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status.Applicants Name: *FirstLastApplicants Address: *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow Many Years Have You Lived At This Address? *Email *EmailConfirm EmailMobile Phone Number: *Home Phone Number:What Is The Position You Are Applying For?What Is Your Desired Salary? *How Did You Hear About Us? *InDeedCraigslistSocial MediaCurrent EmployeeSearch EngineOther - Please Tell Us How BelowIf You Selected Other, Please Tell Us How: *Have You Ever Applied At Matthews Plating Before? *YesNoWhat year did you apply to Matthews Plating? *Are You At Least 18 Years Old? *YesNoDo You Have A Reliable Way To Get To Work? *YesNoAre You Willing To Work Any Shift, Including Nights and Weekends *YesNoIf You Answered No To The Above Question, Please State Your Limitations Here *If You Are Offered Employment, When Would You Be Available To Begin Work? *Are You Legally Eligible For Employment In The United States? *YesNoAre You Able To Perform The Essential Functions Of The Job Position Without Reasonable Accommodation? *YesNoWhat Reasonable Accommodation, If Any Would You Require? *Have You Ever Been Convicted Of Any Crime, Including Traffic Violations? *YesNoIf You Have Been Convicted Of A Crime, Please Describe here: *The existence of a criminal record does not constitute an automatic bar to employment unless relevant to the type of employment. Employment History Please List Your Current Or Most Recent Employment First. You Must List At Least 2 Previous Employers. 1. Previous Employers Name: *1. Start And End Dates of Employment (Month/Year) *1. Previous Employers Address: *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code2. Previous Employers Name: *2. Start And End Dates of Employment (Month/Year) *2. Previous Employers Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code3. Previous Employers Name:3. Start And End Dates of Employment (Month/Year)3. Previous Employers Address:Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEducation And Training Please List Your Education And Training.High School Name: *High School Address: *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLast Grade Completed? *9101112Did You Receive A Diploma? *YesNoWhat Year Did You Graduate? *College Name:Did You Receive A Degree? *YesNoIf Yes, What Degree Did You Receive? *Awards, Honors, Special Achievements: Skills List Any Skills That May Be Useful For The Job You Are Seeking. Enter The Number Of Years of Experience.Skill 1 : *Skill 1 Years Of Experience: *Skill 2:Skill 2 Years Of Experience:Skill 3:Skill 3 Years Of Experience: Personal References List Any 2 People Who Would Be Willing To Provide A Reference For You. 1. Reference Name: *1. Relationship To you: *1. - How Many Years Have You Been Acquainted? *1. Reference Phone Number: *2. Reference Name: *2. Relationship To You: *2. - How Many Years Have You Been Acquainted? *2. Reference Phone Number: *Please Provide Any Other Information That You Believe Should Be Considered: Physical History Please Answer All Physical History Questions.1. - Do you have any trouble with your bones or joints? *YesNo2. - Have you had any shortness of breath, chronic cough or lung troubles? *YesNoIf you answered Yes to question 2, Please explain here: *3. - Have you had any dislocations or fractures? *YesNoIf you answered Yes to question 3, Please explain here: *4. - Do you have any allergies or asthma? *YesNo5. - Have you had a rupture or hernia? *YesNo6. - Do you have frequent headaches? *YesNoIf you answered Yes to question 6, Please explain here: *7. - Have you had a convulsion or a history of seizures? *YesNoIf you answered Yes to question 7, Please explain here: *8. - Have you had any head injuries, blacked out or had head dizziness? *YesNoIf you answered Yes to question 8, Please explain here: *9. - Have you ever been refused work due to health, injury or physical defect? *YesNoIf you answered Yes to question 9, Please explain here: *10. - Can you lift 50 Pounds or more repetitively? *YesNo11. - Do you have a strained or injured back? *YesNoIf you answered Yes to question 11, Please explain here: *12. - Do you have any other serious illness? *YesNoIf you answered yes to question 12, Please explain here: *13. - Have you lost any time due to illness in the past year? *YesNoIf you answered Yes to question 13, Please explain here: *14. - Do you have any ailments or physical defect which might interfere with performing the work applied for? *YesNoIf you answered Yes to question 14, Please explain here: *15. - Are you being treated, or plan on being treated by a doctor? *YesNoIf you answered Yes question 15, Please explain here: *16. - Have you been treated for alcoholism or drugs? *YesNo17. - Have you ever filed a claim or received workers compensation for an injury? *YesNoIf you answered Yes to question 17, Please explain here: *18. - Have you ever been refused a drivers license for health reasons? *YesNoIf you answered Yes to question 18, Please explain here: *19. - Would you pass a drug screen? *YesNo20. - Have you ever been hospitalized? *YesNoIf you answered Yes to question 20, Please explain here. Please also list surgeries you have had: *21. - Have you ever had an on the Job lost time accident? *YesNoIf you answered Yes to question 21, Please explain here: * Certification I certify that the information provided on this Application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my Application, or if employment commences, immediate termination. I authorize Matthews Plating to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education. If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by it's supervisor, the employment relationship will be entirely voluntary in nature. In other words, with appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, My employer would have the same right. Moreover, no agent, representative, or employee of Matthews Plating except in a specific written contract of employment signed on behalf of the organization by it's supervisor, has the power to alter or vary the voluntary nature of the employment relationship. I have carefully read the above certification and I understand and agree to its terms. I Agree *I AgreeSubmit