WCCO Belting Inc, Online Application

Equal access to programs, services, and employment is available to all persons. Those applicants requiring reasonable accomodations to the application and/or interview process should notify a representative of the Human Resource Department.

Position(s) Applied For

Date of Application

Referral Source

Last Name

First Name

Middle Name

Social Security Number

Address

City

State

Telephone Number

Other numbers

Emergency Contact

Emergency Address

Emergency Phone

Best Time To Call You At Home

May We Contact You At Work?

if Yes, Work Number And Time

Submitted Application Before?

Date

Positions

Have Worked Here Before?

If Yes, Give Dates
(From and To)

Are You Legally Eligible for Employement in this Country?

Date Available for Work

Desired Salary Range?

Employment Type

Can You Work Any Shift?

Will You Work Ovetime If Required?

If No, Please Explain

Have You Ever Been Arrested, Pled 'Guilty', 'No Contest', Or Been Convicted Of A Crime?

If Yes, Please Explain

Answering "yes" to these questions does not consitiute an automatic bar to employment. Factors such as dat of offense, seriousness, nature of violation, rehabilitaion and positions applied for will be taken into account.

Educational Background A. List last three(3) schools attended, starting with most recent. B. List number of years completed. C. Indicate degree or diploma earned if any. D. Grade Point Average or Class Rank. E. Major Field of study. F. Minor Field of study (if applicable).
A. School	B. Number of years completed	C. Degree Diploma	D. GPA Class Rank	E. Major	F. Minor

References List name and telephone number of three business/work references who are NOT related to you and NOT previous supervisors. If not applicable, list three school or personal references who are not related to you.
Name	Telephone	Number of years known

Additional Information List professional, trade, business or civic associations and any offices held. Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilites, veteran/reserve national guard or any other similarly protected status.
Organization		Offices Held





List special accomplishments, publications, awards, etc. Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilites, veteran/reserve national guard or any other similarly protected status. List any additional information you would like us to consider.

Employment History Provide the following information of your past and current employers, assignments or volunterr activites, starting with the most recent. Explain any gaps in employment in comments section below.
Employer	Telephone	Dates Employed

Address	Starting Job Title/ Final Job Title	Payrate/Salary

Supervisor	May we contact for reference?

Reason for leaving?

Employer	Telephone	Dates Employed

Address	Starting Job Title/ Final Job Title	Payrate/Salary

Supervisor	May we contact for reference?

Reason for leaving?

Employer	Telephone	Dates Employed

Address	Starting Job Title/ Final Job Title	Payrate/Salary

Supervisor	May we contact for reference?

Reason for leaving?

Comments(including explanation of any gaps in employement.)

Skills and Qualifications Summerize any special training, skills, licenses and/or certificates that may qualify you aas being able to perform job-related functions in the position for which you are applying.