Application for Employment

North American Millwright • 4480 North Point Blvd., Baltimore, Maryland 21219 • Phone: 410-388-9870

Personal Information

Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Phone *

Email *

Apprenticeship School:

First Year
Second Year
Third Year
Fourth Year Graduate

Employment Desired

Position *

Date You can start: *

Salary Desired *

Are You Employed Now? *

If so may we inquire of your present Employer? *

Ever applied to this company before? *

If yes, when? *

Referral Source: *

If yes, who? *

Do any friends or relatives work here? *

If yes, who? *

If yes, describe in full including dates: *

In case of emergency, please notify:

Name *

First

Last

Phone *

Address *

Address Line 1

City

State

Zip Code

Present or Last Employment

Name of Company: *

Address *

Address Line 1

City

State

Zip Code

Position: *

Dates of employment: (to-from) *

Starting Pay: *

Ending Pay: *

Supervisor’s Name: *

First

Last

Phone Number: *

Reason for leaving *

Describe Duties: *

Previous Employment

Name of Company:

Address

Address Line 1

City

State

Zip Code

Position:

Dates of employment:

(from) (to)

Starting Pay:

Ending Pay:

Supervisor’s Name:

Phone

Reason for Leaving:

Describe Duties:

Name of Company:

Address

Address Line 1

Address Line 2

City

State

Zip Code

Position:

Dates of employment:

(from) (to)

Starting Pay:

Ending Pay:

Supervisor’s Name:

Phone:

Reason for Leaving:

Describe Duties:

References

Name

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Relationship:

Address

Address Line 1

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Phone

Name:

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Relationship:

Address:

Address Line 1

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Phone:

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Address Line 1

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Phone:

Disclosures:

North American Millwright Services, Inc. is a drug free work place. Anyone carrying a medical marijuana card must provide a copy of the card with the 16-digit code on it and a doctor’s note stating what medical condition is being treated and what the patient’s limitations and restrictions are. If operating a company vehicle and you receive a violation for speeding or running a red light either by a police office or by camera you are responsible to pay this either by a payroll deduction or cash the same week it is received. North American Millwright Services conducts background searches on all applicants before offering a position. All applicants will be sent for a pre-placement drug screening test. Random drug screens are done monthly. *

I have read and agree to the above statements

Signature *

Signature

Date *

UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.00 *

Signature

Date *

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