EMPLOYMENT APPLICATION

Spencer Industries is always interested in hiring motivated, innovative individuals who are seeking a challenging career and performance based promotions.
An email address is required to submit this application form.


APPLICANT INFORMATION

Full Name:

        Date:


Address:





Phone:

        Email:


Date Available:

        Desired Salary:


Desired Position:

        Desired Location:


Are you a citizen of the United States?    

          If no, are you authorized to work in the United States?    


Have you worked for this company before?    

          If yes, when?



Have you ever been arrested for or convicted of a crime that has not been expunged by a court?    


          If yes, explain:




EDUCATION

High School:


Address:



From:

   To:

      Did you graduate?

      Diploma:





College:


Address:



From:

   To:

      Did you graduate?

      Diploma:





Other:


Address:



From:

   To:

      Did you graduate?

      Diploma:




PREVIOUS EMPLOYMENT

Company:

     Phone:


Address:




Job Title:

     Starting Salary:

     Ending Salary:


Responsibilities:


From:

   To:

      Reason for leaving:


      May we contact your previous supervisor for a reference?




Company:

     Phone:


Address:




Job Title:

     Starting Salary:

     Ending Salary:


Responsibilities:


From:

   To:

      Reason for leaving:


      May we contact your previous supervisor for a reference?




Company:

     Phone:


Address:




Job Title:

     Starting Salary:

     Ending Salary:


Responsibilities:


From:

   To:

      Reason for leaving:


      May we contact your previous supervisor for a reference?




MILITARY SERVICE

Branch:

     From:

   To:


Rank at Discharge:

     Type of Discharge:


If other than honorable, explain:





REFERENCES

Please list three professional references.


Full Name:


Address:



Relationship:

     Company:

     Phone:




Full Name:


Address:



Relationship:

     Company:

     Phone:




Full Name:


Address:



Relationship:

     Company:

     Phone:




DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.


If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.


Signature:

     Date:






INDIANA

902 Buffaloville Road

Dale, IN 47523

SOUTH CAROLINA

831 Elm St E

Hampton, SC 29924

IOWA

14120 Locust Street

Wapello, IA 52653

OHIO

708 Lowell St

Elyria, OH 44035