Online Application

Collins Manufacturing is committed, in accordance with applicable law, to a policy of nondiscrimination and equal opportunity for all qualified applicants and employees, without regard to race, color, religion, national origin, sex, age or status as a veteran.

First name
Middle name
Last name
Address
Home phone
Cell phone
Social security number
List any other name under which you have worked and / or attended school that we should use when making inquiries on your behalf
If hired, can you prove you are authorized to work in the US? yes no
(2) Proofs of identity and eligibility for employment will be required at the time of employment.
If you are under 18 years of age, can you submit a work permit? yes
Have you ever been employed with us before? yes no
If yes, list the location and dates
Are you available to work Full time Part time Temporary
Would you work First shift Second shift Third shift
Preferred shift
On what date would you be available to start work?
If the position for which you are applying requires you to travel as part of the job, are you able to do so? yes no
Have you been convicted of a felony within the last 7 years? yes no
If yes, please explain

convictions will not necessarily disqualify an applicant from employment

Education

 
High School

Name

  Address
  Major course of sudy
  Year completed
  Degree type
  Years attended
Undergraduate

Name

  Address
  Major course of sudy
  Year completed
  Degree type
  Years attended
Graduate

Name

  Address
  Major course of sudy
  Year completed
  Degree type
  Years attended
You may omit an extra-curricular activity that may indicate your race, color, national origin, age, sex, religion or handicap.
Describe any honors you have received
State any additional information you feel may be helpful to us in considering your application
If relevant to the job for which you are applying, please indicate any foreign languages you can speak, read and / or write:

Personal references

 
(not former employers or relatives)  
Reference #1 Name & Occupation
  Address
  Phone
Reference #2 Name & Occupation
  Address
  Phone
Reference #3 Name & Occupation
  Address
  Phone

Record of Employment and / or Military experience

 
Are you currently employed yes no
May we contact your present employer about this application yes no
List most recent experience first
Company name, address, phone
From
To
Job title & description
Salary
Reason for leaving
Supervisors name
   
Company name, address, phone
From
To
Job title & description
Salary
Reason for leaving
Supervisors name
   
Company name, address, phone
From
To
Job title & description
Salary
Reason for leaving
Supervisors name
   
Company name, address, phone
From
To
Job title & description
Salary
Reason for leaving
Supervisors name

Special skills and Qualifications

 
Summarize special job related skills and qualifications accrued from employment or other experiences
   

I certify that all of the information I have provided on this application is true and complete. I understand the falsification, misrepresentation or omission of facts called for in this application may result in denial of employment or immediate dismissal.

I give Collins permission to investigate all information concerning my application in order to determine my qualifications for employment. I understand that any offer of employment may be rescinded if my references are inadequate or unacceptable. I hereby agree to indemnify and hold harmless Collins and all those concerned with it, those whom I have listed as references, my current and former employers and educational institutions that I have attended from any and all liability or claims resulting from, arising out of or in any way connected with their participation in the investigation of this application.

I understand and accept that neither this employment application nor any other Collins document constitutes a personal contact of employment, unless such document expressly so states and is signed by me and an authorized officer of Collins. I further understand that, without such an expressed written contract, my employment is for no stated term and may be terminated by either me or Collins at any time without notice or without cause.

I understand that any offer of employment may be conditioned on a medical examination which includes a drug screening by a doctor selected by Collins to which I hereby consent. I also agree that, if I am hired, I will take such other medical examinations at such other times during my employment as may be required by Collins and execute appropriate consent and medical release forms.

I further understand that any offer of employment may be conditioned on the completion of a satisfactory background investigation to which I hereby consent.

I agree that, if accepted for employment, I will abide by all existing rules and policies of Collins and as these may be changed from time to time.

In the event of resignation or termination, I agree to return all property of Collins loaned to me, included but not limited to identification badges, uniforms, keys and credit cards. I hereby authorize Collins to withhold from final compensation due to me the value of any Collins property that I fail to return and any balance due on company charge cards issued to me at the time my employment ends.

   
Date