Please enable JavaScript in your browser to complete this form. - Step 1 of 4PERSONAL INFORMATIONDate / Time *Applicant Name *FirstLastApplicant Home Phone Number *Applicant Email *Applicant Present Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAre you at least 18 years old? *YesNo(Federal law requires that you be 18 or older to work in some jobs).Do you authorize a background investigation including prior employers, education, and criminal records? *YesNoHas your employment with any other employer ever been involuntarily terminated? *YesNoIf yes, please identify the employer, date of termination and reason for termination: *EMPLOYMENT DESIREDDepartment: *ManufacturingQualityEngineeringMaintenanceOfficeOtherShift Preference: *1st Shift (8am - 4pm)2nd Shift (4pm - 12am)*3rd Shift (12am - 8am)**Shift Differentials: 2nd: Base + $1.50 more per hour 3rd: Base + $2.00 more per hourStatus: *Full TimePart TimeTemporarySalary Expectations: *Specify Other Desired: *Date you can start: *How did you hear about TCI? *Are you currently employeed? *YesNoIf currently employed, may we contact your employer? *YesNoCurrent Employer Phone Number: *NextHave you been employed by Trans Cable before? *YesNoIf yes, when and reason for leaving: *EDUCATIONHigh School - Name and Location of School: *Last Year Completed - HS *1234Did you Graduate? - HS *YesNoSubjects Studied and Degrees Received - HS: *College - Name and Location of School:Last Year Completed - College1234Did you Graduate? - CollegeYesNoSubjects Studied and Degrees Received - College:Trade, business or correspondence school - Name and Location of School:Last Year Completed - Other1234Did you Graduate? - OtherYesNoSubjects Studied and Degrees Received - OtherAdditional Comments, Skills, Etc.:Describe any relevant skills acquired through US Military Services: NOTICE: Offers of employment are contingent on passing screenings, which include a drug/alcohol screen, and security background check. NextFORMER EMPLOYERSList last four employers, starting with the most recent. Employer 1:Employer Name: *Position Held: *Month & Year - From/To: *Reason for Leaving: *Address: *Phone Number: *Person to Contact: *Contacts Position: *Employer 2: Employer Name: *Position Held: *Month & Year - From/To: *Reason for Leaving: *Address: *Phone Number: *Person to Contact: *Contacts Position: *Employer 3:Employer Name: *Position Held: *Month & Year - From/To: *Reason for Leaving: *Address: *Phone Number: *Person to Contact: *Contacts Position: *Employer 4:Employer Name: *Position Held: *Month & Year - From/To: *Reason for Leaving: *Address: *Phone Number: *Person to Contact: *Contacts Position: *Describe fully the nature of the work in your present job (or most recent job): *What special skills or knowledge do you have which will aid you in qualifying for employment? (include tools and machines): *List any certifications or licenses you currently possess: *NextREFERENCES: List below the names of three business references NOT related to you, whom you have known at least one year. If you do not have any employment related references, please list individuals who can comment on your work skills"Reference #1 Name/Position: *Reference #1 Address/Phone # *Reference #1 Company Name *Reference #1 Years Acquainted: *Reference #2 Name/Position: *Reference #2 Address/Phone # *Reference #2 Company Name *Reference #2 Years Acquainted: *Reference #3 Name/Position: *Reference #3 Address/Phone # *Reference #3 Company Name *Reference #3 Years Acquainted: *READ CAREFULLY AND SIGN BELOW IF YOU AGREE TO THESE TERMS OF EMPLOYMENT:I understand that the employer follows an “employment at will” policy, in that I or the employer may terminate my employment at any time or for any reason consistent with applicable state and federal law; this “employment at will” policy cannot be changed verbally or in writing, unless the change is specifically authorized in writing by the chief operating officer of this organization. I understand that this application is not a contra ct of employment. I understand that federal law prohibits the employment of unauthorized aliens; all persons hired must submit satisfactory proof of employment a uthorization and identity; failure to submit such proof will result in denial of employment. I understand this application will be active for a period of 60 days; after that time, if I wish to be considered for employment, I must submit a new applicati on. I understand that the employer will thoroughly investigate my work and personal history and verify all data given on this app lication, on related papers, and in interviews. I authorize all individuals, schools, and firms named therein, except my current employer if so noted, to provide any information requested about me, and I release them from all liability for damage in providing this information. I also authorize and request federal, state and local governmental agencies to release to Trans Cable International any information requested concerning criminal convictions on my record. I agree to submi t to screenings permitted by law before and during my employment by a health care professional, at the request and expense of Trans Cable International, I agr ee to disclose completely all information lawfully requested about my physical and mental condition and medical history. I also agree I will cooperate in such lawful medical tests as Trans Cable International requests to check for drugs or alcohol in my system or for any other physical condition. I waive and rele ase and promise not to make claims against Trans Cable International relating to any such testing or from lawful decisions made regarding my employment or termination of employment based upon the results of such testing or analysis.I certify that all the statements herein are true and understand that any falsification o r willful omission shall be sufficient cause for dismissal or refusal of employment. A photocopy of this signed authorization and waiver shall be valid as an original.Date: *Full Name: *Upload Resume Click or drag files to this area to upload. You can upload up to 5 files. Submit
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