"*" indicates required fields Step 1 of 7 14% APPLICATION FOR EMPLOYMENT Enerquip, LLC is an equal opportunity employer dedicated to a policy of non-discrimination in employment based upon an individual's race, color, creed, religion, age, gender, national origin, ancestry, veteran status, marital status, sexual orientation or the presence of any non‑job‑related medical condition or disability, or other characteristics protected by law. In reading and answering the following questions, please keep in mind that none of the questions are intended to imply any limitations, illegal preferences, or discrimination based upon any non‑job‑related information. This application will be given consideration, but its receipt does not imply that the applicant will be interviewed or employed. If you need an accommodation to participate in the application process, please contact our Human Resource Department at (715) 748-5888. APPLICANT INFORMATIONFirst Name* Middle Name* Last Name* Address* Address Line 1 Address Line 2 City State ZIP Code Email Address* Preferred Telephone*Alternate TelephoneAll new hires will be required to provide documentation establishing identity and legal right to work in the United States. Do you have a legal right to work in this country?* Yes No Are you 18 years of age or older?* Yes No EMPLOYMENT INFORMATION Position Applying For:* Type of Employment Desired* Full-Time Part-Time LTE Seasonal Date Available to Begin Employment* How did you become aware of this position?* Newspaper Referral from a Friend/Relative School Enerquip.com Indeed.com Other Explain EDUCATION Please check all that apply.* High School College Graduate School Other Education Check All High SchoolHigh School Name & Location (City, State) High School Major Subjects High School Diploma or GED? Yes No College College Name & Location (City, State) College # Years Attended College Degree & Major/Minor(s) College Degree or Diploma Earned? Yes No Would you like to add another college? Yes No Graduate School Graduate School Name & Location (City, State) Graduate School # Years Attended Graduate School Degree & Major Graduate Degree Earned? Yes No Other EducationSchool Name & Location (City, State) School # Years Attended School Degree, Diploma or Certificate & Major Degree, Diploma or Certificate Earned? Yes No TRAINING COURSES OR SEMINARSWould you like to list any relevant training courses or seminars you have completed?* Yes No How many courses or seminars would you like to add? 1 2 3 4 Course/Seminar Name & Content #1Date(s) Attended Course/Seminar Name & Content #2Date(s) Attended Course/Seminar Name & Content #3Date(s) Attended Course/Seminar Name & Content #4Date(s) Attended LICENSES & CERTIFICATIONS Do you have any relevant licenses and/or certifications you would like to list?* Yes No How many licenses/certifications would you like to add? 1 2 3 4 License/Certification & State Issued License/Certification & State Issued License/Certification & State Issued License/Certification & State Issued EMPLOYMENT HISTORY BEGIN WITH MOST RECENTHow many previous employers would you like to list?** 1 2 3 4 5 No previous employment history EMPLOYER 1Name of Employer 1* Type of Business TelephoneAddress (Street, City, State) Employment Dates (from month/year to month/year) Job Title Status Full-Time Seasonal Limited Term Contracted Description of DutiesName of Immediate Supervisor & Job Title Salary Start Salary End Reason for Leaving May we contact this employer as a reference? Yes No EMPLOYER 2Name of Employer 2* Type of Business TelephoneAddress (Street, City, State) Employment Dates (from month/year to month/year) Job Title Status Full-Time Seasonal Limited Term Contracted Description of DutiesName of Immediate Supervisor & Job Title Salary Start Salary End Reason for Leaving May we contact this employer as a reference? Yes No EMPLOYER 3Name of Employer 3* Type of Business TelephoneAddress (Street, City, State) Employment Dates (from month/year to month/year) Job Title Status Full-Time Seasonal Limited Term Contracted Description of DutiesName of Immediate Supervisor & Job Title Salary Start Salary End Reason for Leaving May we contact this employer as a reference? Yes No EMPLOYER 4Name of Employer 4* Type of Business TelephoneAddress (Street, City, State) Employment Dates (from month/year to month/year) Job Title Status Full-Time Seasonal Limited Term Contracted Description of DutiesName of Immediate Supervisor & Job Title Salary Start Salary End Reason for Leaving EMPLOYER 5Name of Employer 5* Type of Business TelephoneAddress (Street, City, State) Employment Dates (from month/year to month/year) Job Title Status Full-Time Seasonal Limited Term Contracted Description of DutiesName of Immediate Supervisor & Job Title Salary Start Salary End May we contact this employer as a reference? Yes No VOLUNTEER, SPECIAL SKILLS, AWARDS Describe any volunteer work relative to the job you are seeking:If relevant, please describe your computer knowledge and office equipment experience:If relevant, please describe your experience using machinery and equipment:List any organizations you are a member of or any job-related honors or awards you have received which are relevant to the job you are seeking: PROFESSIONAL REFERENCE 1 List individuals familiar with your job qualifications.Name* Telephone*Address (Street, City, State)* Relationship* Number of years have known?* PROFESSIONAL REFERENCE 2 List individuals familiar with your job qualifications.Name* Telephone*Address (Street, City, State)* Relationship* Number of years have known?* PROFESSIONAL REFERENCE 3 List individuals familiar with your job qualifications.Name* Telephone*Address (Street, City, State)* Relationship* Number of years have known?* PENDING CHARGES / CONVICTIONS Conviction of a crime or pending charges is not an automatic bar to employment. Enerquip will consider the nature of the offense, the date of the offense and the relationship between the offense and the position for which you are applying to determine if the conviction or pending charges substantially relates to the position for which you are applying. Is there a criminal charge, felony or misdemeanor, currently pending against you?* Yes No Please give a brief description of the pending charge to include the date issued and the state where issued.Have you ever been convicted of a crime, felony or misdemeanor?* Yes No Please give a brief explanatory statement to include the date of conviction and state in which convicted.Signature*NameThis field is for validation purposes and should be left unchanged. Δ
