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NAME: _________________________________________________________________________________
JOB TITLE: ______________________________________________________________________________
ADDRESS: ______________________________________________________________________________
TELEPHONE NO.: ( _____ ) ___________________________CHECK ONE: ____ WORK REFERENCE
____ PERSONAL REFERENCE
NAME: _________________________________________________________________________________
JOB TITLE: ______________________________________________________________________________
ADDRESS: ______________________________________________________________________________
TELEPHONE NO.: ( _____ ) ___________________________CHECK ONE: ____ WORK REFERENCE
____ PERSONAL REFERENCE
NAME: _________________________________________________________________________________
JOB TITLE: ______________________________________________________________________________
ADDRESS: ______________________________________________________________________________
TELEPHONE NO.: ( _____ ) ___________________________CHECK ONE: ____ WORK REFERENCE
____ PERSONAL REFERENCE
REFERENCESPLEASE LIST THREE REFERENCES (WORK RELATED AND/OR PERSONAL) WE MAY CONTACT.
I CERTIFY THAT THE ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE. I AUTHORIZE INVESTIGATIONOF ALL STATEMENTS CONTAINED IN THIS APPLICATION FOR EMPLOYMENT. I HEREBY UNDERSTANDAND ACKNOWLEDGE THAT, UNLESS OTHERWISE DEFINED BY APPLICABLE LAW, ANY EMPLOYMENTRELATIONSHIP WITH NACHI IS OF AN “AT WILL” NATURE, WHICH MEANS THAT THE ASSOCIATE MAYRESIGN AT ANY TIME AND THE EMPLOYER MAY DISCHARGE THE ASSOCIATE AT ANY TIME WITH OR WITHOUT CAUSE. IT IS FURTHER UNDERSTOOD THAT THIS “AT WILL” EMPLOYMENT RELATIONSHIP MAY NOT BE CHANGED BY ANY WRITTEN DOCUMENT OR BY CONDUCT UNLESS SUCH CHANGE IS SPECIFICALLY ACKNOWLEDGED IN WRITING BY AN AUTHORIZED EXECUTIVE OF NACHI AND ITS SUBSIDIARIES. IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW(S) MAY RESULT IN DISCHARGE. I UNDERSTAND, ALSO, THAT I AM REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF NACHI.
___________________________________________________________________ ______________________________
ETAD TNACILPPA FO ERUTANGIS
NACHI IS AN EQUAL OPPORTUNITY EMPLOYER.NACHI CONSIDERS APPLICANTS FOR ALL POSITIONS WITHOUT REGARD TO RACE COLOR, RELIGION, CREED, GENDER, NATIONAL
ORIGIN, DISABILITY, MARITAL OR VETERAN STATUS, SEXUAL ORIENTATION, OR ANY OTHER LEGALLY PROTECTED STATUS.
EMAN ELDDIMEMAN TSALEMAN TSRIF
PIZ / ETATSYTICSSERDDA TEERTS
REBMUN YTIRUCES LAICOSREBMUN ENOHPELET ETANRETLAREBMUN ENOHPELET
DO YOU HAVE ANY FRIENDS OR RELATIVES WORKING HERE?
YES
________
IF “YES” WHO:
________
_________________________________
HAVE YOU BEEN EMPLOYED HERE BEFORE?
YES________SEY_____
_____ NO IF “YES” WHEN:_____________________________ ________
ARE YOU CURRENTLY ON “LAY OFF” STATUS AND
SUBJECT TO RECALL?
_______
YES _______ NO
MAY WE CONTACT YOU AT WORK IF NECESSARY?SEY___________
_______ YES _______ NO
TELEPHONE NUMBER:
ON
_____________________________
?SEITINUTROPPO IHCAN TUOBA RAEH UOY DID WOHTSALEHT NI EMIRC A FO DETCIVNOC NEEB UOY EVAH
SEVEN (7) YEARS? (CONVICTION WILL NOT NECESSARILY DISQUALIFY APPLICANT) _______ FRIEND/RELATIVE _____ EMPLOYMENT
_____ YES IF “YES” PLEASE EXPLAIN: _______________________________ _______ WORD OF MOUTH ____ OTHER______________
_____ NO _________________________________________________________
POSITION DESIRED
_____MACHINE OPERATOR _____SHIPPING/RECEIVING
_____TURNING _____QUALITY
_____GRINDING _____SUPERVISION
_____ASSEMBLY _____OFFICE
_____PRODUCTION MAINTENANCE _____OTHER ______________________
______________________
INDICATE SHIFT PREFERENCE (1ST, 2ND, 3RD CHOICE)
________ 7:00 A.M. - 3:30 P.M.
________
________
LEAVE BLANK ANY SHIFT YOU ARE UNABLE TO WORK
(PROOF OF U.S. CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT)
_______ TEMPORARY SERVICE ________________
ARE YOU CURRENTLY EMPLOYED?:
ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE U.S.?
713 PUSHVILLE ROADGREENWOOD, IN 46143
PHONE: 317-535-5000 FAX: 317-535-8484
715 PUSHVILLE ROADGREENWOOD, IN 46143
PHONE: 317-530-1001 FAX: 317-530-1011
717 PUSHVILLE ROADGREENWOOD, IN 46143
PHONE: 317-535-0320 FAX: 317-535-0983
___________
NO
NO
3:00 P.M. - 11:30 P.M.
11:00 P.M. - 7:30 A.M.
EMAIL ADDRESS
________ *12 HOUR (7:00 P.M - 7:30 A.M)
NAME: _________________________________________________________________________________
JOB TITLE: ______________________________________________________________________________
ADDRESS: ______________________________________________________________________________
TELEPHONE NO.: ( _____ ) ___________________________CHECK ONE: ____ WORK REFERENCE
____ PERSONAL REFERENCE
NAME: _________________________________________________________________________________
JOB TITLE: ______________________________________________________________________________
ADDRESS: ______________________________________________________________________________
TELEPHONE NO.: ( _____ ) ___________________________CHECK ONE: ____ WORK REFERENCE
____ PERSONAL REFERENCE
NAME: _________________________________________________________________________________
JOB TITLE: ______________________________________________________________________________
ADDRESS: ______________________________________________________________________________
TELEPHONE NO.: ( _____ ) ___________________________CHECK ONE: ____ WORK REFERENCE
____ PERSONAL REFERENCE
REFERENCESPLEASE LIST THREE REFERENCES (WORK RELATED AND/OR PERSONAL) WE MAY CONTACT.
I CERTIFY THAT THE ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE. I AUTHORIZE INVESTIGATIONOF ALL STATEMENTS CONTAINED IN THIS APPLICATION FOR EMPLOYMENT. I HEREBY UNDERSTANDAND ACKNOWLEDGE THAT, UNLESS OTHERWISE DEFINED BY APPLICABLE LAW, ANY EMPLOYMENTRELATIONSHIP WITH NACHI IS OF AN “AT WILL” NATURE, WHICH MEANS THAT THE ASSOCIATE MAYRESIGN AT ANY TIME AND THE EMPLOYER MAY DISCHARGE THE ASSOCIATE AT ANY TIME WITH OR WITHOUT CAUSE. IT IS FURTHER UNDERSTOOD THAT THIS “AT WILL” EMPLOYMENT RELATIONSHIP MAY NOT BE CHANGED BY ANY WRITTEN DOCUMENT OR BY CONDUCT UNLESS SUCH CHANGE IS SPECIFICALLY ACKNOWLEDGED IN WRITING BY AN AUTHORIZED EXECUTIVE OF NACHI AND ITS SUBSIDIARIES. IN THE EVENT OF EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW(S) MAY RESULT IN DISCHARGE. I UNDERSTAND, ALSO, THAT I AM REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF NACHI.
___________________________________________________________________ ______________________________
ETAD TNACILPPA FO ERUTANGIS
NACHI IS AN EQUAL OPPORTUNITY EMPLOYER.NACHI CONSIDERS APPLICANTS FOR ALL POSITIONS WITHOUT REGARD TO RACE COLOR, RELIGION, CREED, GENDER, NATIONAL
ORIGIN, DISABILITY, MARITAL OR VETERAN STATUS, SEXUAL ORIENTATION, OR ANY OTHER LEGALLY PROTECTED STATUS.
EMAN ELDDIMEMAN TSALEMAN TSRIF
PIZ / ETATSYTICSSERDDA TEERTS
REBMUN YTIRUCES LAICOSREBMUN ENOHPELET ETANRETLAREBMUN ENOHPELET
DO YOU HAVE ANY FRIENDS OR RELATIVES WORKING HERE?
YES
________
IF “YES” WHO:
________
_________________________________
HAVE YOU BEEN EMPLOYED HERE BEFORE?
YES________SEY
_____
_____ NO IF
“YES”
WHEN:_____________________________ ________
ARE YOU CURRENTLY ON “LAY OFF” STATUS AND
SUBJECT TO RECALL?
_______
YES _______ NO
MAY WE CONTACT YOU AT WORK IF NECESSARY?SEY___________
_______ YES _______ NO
TELEPHONE NUMBER:
ON
_____________________________
?SEITINUTROPPO IHCAN TUOBA RAEH UOY DID WOHTSAL
EHT NI EMIRC A FO DETCIVNOC NEEB UOY EVAH
SEVEN (7) YEARS? (CONVICTION WILL NOT NECESSARILY DISQUALIFY APPLICANT) _______ FRIEND/RELATIVE _____ EMPLOYMENT
_____ YES IF “YES” PLEASE EXPLAIN: _______________________________ _______ WORD OF MOUTH ____ OTHER______________
_____ NO _________________________________________________________
POSITION DESIRED
_____MACHINE OPERATOR _____SHIPPING/RECEIVING
_____TURNING _____QUALITY
_____GRINDING _____SUPERVISION
_____ASSEMBLY _____OFFICE
_____PRODUCTION MAINTENANCE _____OTHER ______________________
______________________
INDICATE SHIFT PREFERENCE (1ST, 2ND, 3RD CHOICE)
________ 7:00 A.M. - 3:30 P.M.
________
________
LEAVE BLANK ANY SHIFT YOU ARE UNABLE TO WORK
(PROOF OF U.W. CITIZENSHIP OR IMMIGRATION
STATUS WILL BE REQUIRED UPON EMPLOYMENT)
_______ TEMPORARY SERVICE ________________
ARE YOU CURRENTLY EMPLOYED?:
ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE U.S.?
713 PUSHVILLE ROADGREENWOOD, IN 46143
PHONE: 317-535-5000 FAX: 317-535-8484
715 PUSHVILLE ROADGREENWOOD, IN 46143
PHONE: 317-530-1001 FAX: 317-530-1011
717 PUSHVILLE ROADGREENWOOD, IN 46143
PHONE: 317-535-0320 FAX: 317-535-0983
___________
NO
NO
3:00 P.M. - 11:30 P.M.
11:00 P.M. - 7:30 A.M.
EMAIL ADDRESS
________ *12 HOUR (7:00 P.M - 7:30 A.M)