* indicates a response is required Personal Information *Full Name: *Date Applying: *Current Permanent Address: Previous Address #1: Previous Address #2: *Cell Phone: *Accepts texts?YesNo Alternate Phone: *Email: *Are you over the age of 18?YesNo Referred by: *How did you hear about this position? (Check or write in) Walk-inIndeedReferralOther *I have reliable transportation?YesNo Do you know any current employees?YesNo Employment Desired *Position: *Start Date: *$ Rate Desired: *Preferred Shift(s) (check all that apply): DayAfternoonMidnightOther *Ever apply to AML before?YesNo Estimated Date: Check days you cannot work: MTWTHFSSU Education History Name & Location of School Years Attended Did you Graduate? Subjects Studied High School: YesNo College: YesNo Trade: YesNo Other: YesNo Degrees, certificates, special skills, licenses, (other) obtained: Military Service *Served in the The U.S. Armed Forces:YesNo Military Branch Served: Years of Service: Rank: Work History - Current Are you CURRENTLY employed? YesNo Who is your current employer? Do you need a 2-week notice? YesNo Employer Phone No: May we contact this employer? YesNo Employer Contact Person: Work History - Previous Date Worked Month & Year Employer Info Rate/Salary Job Title & Job Duties Reason for Leaving Job #1 Start: Business Name: Phone No: Stop: Address: Contact Person: May we contact this employer? YesNo Job #2 Start: Business Name: Phone No: Stop: Address: Contact Person: May we contact this employer? YesNo Job #3 Start: Business Name: Phone No: Stop: Address: Contact Person: May we contact this employer? YesNo References(list of professional references whom we may contact) # Name Relationship Phone No *1 *2 *3 Special Purpose Questions - (Answer All Questions, including Job functions) Please answer the following questions to complete this AML employment application. Thereby indicating that the information is required for a bona fide occupational qualification, or dictated by national security laws, or is needed for other legally permissible reasons. The information disclosed will not be used to discriminate against you, the applicant, during the hiring process for any reasons relating to race, color, sex, religious affliction, national origin, gender, or any disability. *Question 1: Are you legally qualified to work in the The United States? YesNo *Question 2: I understand, agree, and consent that during my pre-employment or probationary period I may be required to take one or more of the following tests: Physical (Vison & Hearing), Respirator Fit Test, Drug/ Alcohol Test, or future tests TBD as a condition of hiring or continued employment. I agree to consent to take such tests at such time as designated by AML Industries, Inc. and to release the company, its directors, officers, agents, or employees from any claim arising in connection with the use of such tests, other than claims related to privacy violations and/or discrimination under applicable federal & state laws. I understand that all potential employees are required to take the same tests and that, in compliance with federal law the records of such tests will be kept confidential, and the information obtained will not be used to discriminate based on disability, health problems, or medical conditions. By signing this application, I agree to consent to all the above. YesNo *Question 3: I understand, agree, and consent that during my pre-employment process, AML may conduct a background check as a condition of hiring or continued employment. I am willing to discuss and explain any results that may arise from my background check. I understand that all potential employees are required to have a background check and that in compliance with federal law the records of such tests will be kept confidential, and the information obtained will not be used to discriminate. Results will be reviewed to determine job suitability and federally compliant, FCRA, steps will be taken to notify you in the event you are not hired, based on results. All communication will be managed through the applicant portal of the consumer reporting company, that supplied the report. By signing this application, I agree to consent to all the above. YesNo *Question 4: Is English your primary language (speak, read & write fluently? YesNo If not, what is? *Question 5: Are you able to communicate effectively? YesNo *Question 6: Are you able to perform each of the following job functions? Answer all below *Are you able to work in a dirty environment? YesNo *Are you able to use/operate/respect a computer and similar technology/devices? Including programs: Microsoft Office Suite, ERP program, basic troubleshooting YesNo *Are you able to lift 50 lbs? YesNo *Are you able to work on heights? (Ladders and 18; mezzanines) YesNo *Are you able to calculate simple math? YesNo *Are you able to operate a forklift? Do you have any material handling experience? If yes, please explain: YesNo YesNo *Are you able to operate heavy machinery? Do you have any experience? If yes, please explain: YesNo YesNo *Are you able to operate Lab Equipment? Do you have any experience with Lab Equipment? If yes, please explain: YesNo YesNo *Are you able to comply with all company safety rules, policies/practices; including PPE? Including: OSHA, GHS, EPA, ANSI, NFPA, and other similar standards/regulations/guidelines YesNo *Are you able to comply with all company policies and employee handbook? Including: Respect for company hierarchy, ISO (QMS) and other internal practices (ex: worksheets/orders), other company certification/affiliation related compliance. YesNo Additional Information you'd like to add: I certify that all answers given herein are true and complete to the best of my knowledge, authorize investigation/contact of all statements and listed by myself, and understand false or misleading information given may result in rejection or discharge. Name Printed: Date:
