Custom Machine Inc : Application for Employment

CUSTOM MACHINE APPLICATION FOR EMPLOYMENT Equal Opportunity Employer
PERSONAL INFORMATION
Last name:
First name:
Social Security number:
E-mail address:
Present address:
City:
State:
Zip:
Phone number:
Cell number:
Referred by:
U.S. citizen?	check if yes
If not, do you have a green card?	check if yes
Have you ever been convicted of a felony?	check if yes
If so, explain:
POSITION DESIRED
Position:*
Date you can start:	(Date m/d/yy)
Desired salary:
Are you currently employed?	check if yes
If so, may we speak to your current employer?	check if yes
Have you ever applied for a job at Custom Machine, inc. before?	check if yes
When?	(Date m/d/yy)
EDUCATION HISTORY Name and location of school
Grammar school:
Years attended:
Did you graduate?	check if yes
Subjects studied:
High school:
Years attended:
Did you graduate?	check if yes
Subjects studied:
College-undergraduate:
Years attended:
Did you graduate?	check if yes
Subjects studied:
College-graduate:
Years attended:
Did you graduate?	check if yes
Subjects studied:
trade of business school:
Years attended:
Did you graduate?	check if yes
Subjects studied:
Special training, skills:
U.S. military branch:
Rank at discharge:
Type of discharge:
If not honorable, explain:
FORMER EMPLOYERS List the last four employers, starting with most recent
Employer name:
Address:
Dates worked, from:	(Date m/d/yy)
to:	(Date m/d/yy)
Salary:
Position:
Reason for leaving:
Employer name:
Address:
Dates worked, from:	(Date m/d/yy)
to:	(Date m/d/yy)
Salary:
Position:
Reason for leaving:
Employer name:
Address:
Dates worked, from:	(Date m/d/yy)
to:	(Date m/d/yy)
Salary:
Position:
Reason for leaving:
Employer name:
Address:
Dates worked, from:	(Date m/d/yy)
to:	(Date m/d/yy)
Salary:
Position:
Reason for leaving:
REFERENCES List three persons, not related to you, whom you have known for at least one year
Name:
Years known:
Business:
Address:
Name:
Years known:
Business:
Address:
Name:
Years known:
Business:
Address:
Name:
Years known:
Business:
Address:
AUTHORIZATION “I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application may be grounds for dismissal. I authorize investigation of all statements contained herein, and the references and employers listed above, to give you any and all information concerning my previous employment and any pertinent information that they may have, personal or otherwise, and release the company from all liability for any damage that may result from ultilization of such information. I also understand and agree that no representative of the company had any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevent federal and state laws.”
I authorize this information:	check if yes
TESTING REQUIREMENT As you are all well aware, aircraft components represent the majority of Custom Machine’s customer base. This industry as we all know has the most stringent regulations of all the industries we service. The consequences of inferior product and the legal ramifications of poor judgement can place passengers and crew at risk. To minimize human and legal risk, the industry is now requiring manufacturers of any product used in any aircraft to be complient to the FAA Drug and alcohol testing program. As we move towards more advance components and assemblies, our responsibilities become greater. Our customers will depend on our infrastructure to guaranty product integrity and safety. They will no longer inspect product to lower level requirements but as an entire sub assembly. In the event of a catastrophic failure, we would no doubt be part of the investigation and we will need to prove that we are compliant to these regulations. Custom Machine, Inc. has contracted Foley Services to assist in the implementation of a program called “FAA APPROVED DRUG & ALCHOHOL TESTING COMPLIANCE PROGRAM”. We have begun the implementation of this program as of February 1, 2007. This program will require an initial training meeting to explain the program and inform you of your responsibilities as an employee. The date for this meeeting will be announced. Also you may be required to take an initial base line test. Testing is random so you must be ready at a moments notice to report off site for testing. Your participation in this program is mandatory. We must comply in order to conform with the new FAA standard.
I agree to drug and alcohol testing requirement:	check if yes

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781.935.4940

sales@custommachineinc.com