A&C Plastics, Inc.
6135 Northdale * Houston, TX 77087-5095 *
Phone
(713) 645-4915 *
Fax
(800) 627-5899
(U.S.) 1-800-231-4175 *
e-Mail:
plastic@acplasticsinc.com
*
Website:
www.acplasticsinc.com
EMPLOYMENT APPLICATION
Applications are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job-related medical condition or handicap.
PERSONAL INFORMATION:
Date:
Start Date:
Full Time
Part Time
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Referral Source:
Name:
Position Applying for:
Business Name:
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City/State/Zip:
SSN:
Email:
Have you ever been convicted of or charged with a felony or misdemeanor:
Yes
No If yes, please explain details in full, including dates, details of offense(s) jurisdiction and disposition of case:
Have you, or any person or entity with whom you have been associated with, field for bankruptcy, been declared bankrupt or insolvent or been the subject of any receivorship proceedings within the last 7 years?
Yes
No If Yes, please provide full details , including dates, places, amounts involved and disposition:
EDUCATION:
Schools/Colleges Attended:
# Years
Year Grad
Degree
EMPLOYMENT/WORK EXPERIENCE:
Start with your present or most recent position. Include military service assignments and volunteer activities. Exclude organization names that indicate race, color, religion, sex or national origin.
Employer:
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BUSINESS REFERENCES:
Please provide individual and company names, position, addresses, and phone numbers for 3 business references.
Name:
Company:
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PERSONAL REFERENCES:
Please provide names, addresses, phone numbers, relationship and how long known for 3 personal references.
Name:
Company:
Street Address:
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Name:
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City/State/Zip:
Phone:
Name:
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SPECIAL SKILLS:
Describe any special skills or qualifications for this work:
I CERTIFY that the above answers are true and complete to the best of my knowledge. I authorize
, to investigate any statement contained in this application, and to obtain a credit report on me (and my company if this application is for reselling by a company) as necessary to determine agreement. In the event of employment, I understand that any false or misleading information given in my application, correspondence, discussions or interview may result in immediate termination I understand also, that I am required to abide by all rules, regulations and policies of
.
Signed:
Date: