W194N11481 McCormick Dr., P.O. Box 309, Germantown, WI 53022   

(800) 643-5424

Employment Application

Applicant Information













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If hired, you will be required to provide proof of work authorization.


If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and have obtained a valid work permit.



Convictions are not an automatic bar to employment.  If yes, answer the following:














Special Skills



Education









Training Courses


Required Licenses


Employment History

Please enter your most recent employment. All other employment should be provided with your resume as an attachment.


Employment History 1:













Employment History 2:













Employment History 3:













Employment History 4:












Employment References

Please list individuals familiar with your job qualifications (no relatives or personal friends). All other references should be provided with your resume as an attachment.


Reference 1:







Reference 2:







Reference 3:






Attachments

Please upload your resume including a complete employment history and references.


Acknowledgement

Please read carefully before signing this form.

  1.  All information contained in this application is true and correct to the best of my knowledge and belief, I understand that misrepresentations or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired.
  2. I authorize the company to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I hove provided and/or for the purpose of obtaining any information, whether favorable or unfavorable, about me or my employment, I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment.
  3. I understand that passing a drug screen of the company's clinic of choice is required before any job offer will be mode and that for certain positions (all production positions and some office positions), passing a fitness for duty exam is also required before any job offer will be made.
  4. Regardless of whether or not I become employed by the company, I recognize that this application is not and should not be considered a contract of employment, I understand that employment of the company is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company's, unless specifically provided otherwise in a written employment contract, I further understand that no company employee or representative has the authority to enter into a contract regarding duration or terms or conditions of employment other than an officer or official of the company, and then only by means of a signed, written document.


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Voluntary Self-Identification

The information requested below is used by Systems, lnc. only to maintain records required of employers doing business with the federal government, YOU DO NOT HAVE TO ANSWER THESE QUESTIONS TO BE CONSIDERED FOR EMPLOYMENT WITH SYSTEMS, lNC.  If you choose to respond, any information supplied by you on this voluntary supplement will not affect your employment opportunities with Systems, lnc. which is on equal employment opportunity employer.



If yes, please answer the questions below.

If no, please skip and click submit.










Disabled Individuals Special Disabled Veterans/Other Protected Veterans

Providing the information requested below is voluntary and will assist in maintaining affirmative action programs to promote employment opportunities of disabled individuals, special disabled veterans, and other protected veterans. Such disclosure by you will further enable the company to assist you in an appropriate manner concerning your employment. Disclosure or refusal to provide such information will in no way result in adverse treatment. All information regarding your disability will be kept confidential and will be sued only in ways consistent with federal reporting requirements, except that (1) supervisors and managers may be informed regarding restrictions on the work duties of individuals with disabilities and disabled-veteran employees, and regarding necessary accommodations; (2) first-0aid and safety personnel may be informed, when and to the extent appropriate, if a conditions might require emergency treatment; and (3) government officials engaged in enforcing the Americans with Disabilities Act and laws regulating government contractors may be informed.

 

  1. Individual with Disability - defined as a person who...
    • A. Has a physical or mental impairment which substantially limits one or more of your major life activities.
    • B. Has a record of such an impairment, or
    • C. Is regarded as having such an impairment.
  2. Special Disabled Veteran - defined, as...
    • A. A veteran who is entitled to compensation (or who but for the receipt of Military retirement pay would be entitled to compensation) under laws administered by the Department of Veteran Affairs of a disability.
      • 1. Rated at 30 percent or more, or
      • 2. Rated at 10 to 20 percent in the case of veteran who has been determined under section 1506 of Title 38, U.S.C., to have a serious employment handicap, or
      • 3. A person who was discharged or released from active duty because of a service connected disability.
  3. Veteran of Vietnam Era - defined as a person who served more than 180 days of active military, naval, or air service, any part of which was during the period of February 28, 1961 through May 5, 1975; and
    • A. Was discharged or released there with other than a dishonorable discharge, or
    • B. Was discharged or released from active duty because of a service-connected disability.
  4. Other Eligible Veterans
    • A. Veterans who served in a war including veterans with active duty service between December 7, 1941 and April 28, 1952, or
    • B. Veterans who served in a campaign or on an expedition for which a campaign badge, a service medal, or an expeditionary medal has been awarded.






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