INDUSTRIAL Name:* First Last Middle Address:* Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip CodePhone:* Area Code - Phone Number Other Phone :* Area Code - Phone Number E-mail:* I have used Tower Staffing, Inc. in the past :yesHave you ever been convicted of a crime? :*yesnoIf yes, please explain below :EMPLOYMENT HISTORYCurrent or most recent employer: Job title : Reason for leaving? :Job title: Start date: Ending date: Starting Salary : Ending Salary: Description of your duties :Name of Supervisor : Phone # for Supervisor : Area Code - Phone Number May we contact them?:yesnoNext most recent employer: Starting date: End date: Reason for leaving?:Starting Salary: Ending Salary : Description of your duties:Name of Supervisor: Phone # for Supervisor: Area Code - Phone Number May we contact them? :yesnoCheck any items that you own :Safety GlassesWork GlovesSteel Toe Safety ShoesLeather Work ShoesHearing ProtectionHard HatCheck any that pertain to your current work conditions :Can lift over 75 lbsCan lift over 50 lbsNo lifting over 30 lbsLeather Work ShoesHearing ProtectionHard HatNUMBER OF YEARS EXPERIENCE (NUMBERS ONLY, PLEASE)BUILDING MAINTENANCEBuffer Machine: Floor Stripping : Maintenance/Janitorial Hospital Housekeeping : Waxing Machine : Carpet Cleaning Machine : Heating / Cooling : Handyman / Repair : Motel / Hotel Housekeeping : FACTORY WORKAssembly Line: Deburring : Fin Machine Helper : Glass Worker : Mechanical Assembly : Supervisor : Sewing Experience : QC - Coord Measuring Mach : Bench Work : Hand Grinder : Soldering - Hand : General Shop Helper : Quality Control - Manual : Quality Control - visual dimension : Quality Cont-Caliper Quality Cont-Uses SPC Foundry Work : Packing : Cutting Torch : Machine Helper : Tube Pushing : Quality Control - Caliper SPC : Tube Bending : Quality Cont-Visual Operator Turret Lathe : Die Casting : Quality Control - Uses : Fiber Glass : QC - Geom Toler : Soldering Machine : Quality Control - Micrometer : Fiberglass MACHINE OPERATIONSOperator - Brake Press Extruder : Operator - Cut Off Saw Machine : Operator - Punch Press Machine : Operator - Strippit Machine : Operator - CNC : Operator-Brake Machine Mechanically Inclined Operator-Manual CNC Operator - Tappers Machine : Operator - Lathe Injection Mold : Operator - Radical Drill : Operator - Sanding : Operator - Mill : Operator-Swiss Mill(1) Operator-Swiss Mill Operator-Roto-Molder Operator - Grinder : Operator - Screw Machine Press : Operator - Roll Threader : Operator Drill Press : Uses Precision Measuring Inst. : Operator-Swiss Lathe Brown & Sharpe Machine Operator-Plasma Operator - Brake : Operator - Stamping : Operator - Shear Machine : Operator - Plastic Injection: Operator-Plastic Extruder Operator-Mazak Operator-Lathe STOCK ROOMFood Service General : Salad Prep : Expeditor : Kardex Inventory : Computer Inventory : Factory Stock Room : Warehouse Stock Room : Physical Inventory : Factory Stock Room Retail Stock Room : Know Electrical Component : FOOD SERVICESFast Food : Cafeteria : Food Service General Cook : Food Server : Cashier - Food Services : Hotel Experience : Forklift Operator Non - Cert. : Baker : Dishwasher : Deli Experience : Salad Prep WAREHOUSEForklift Operator Cert. : Standup Forklift Non - Cert : Pallet Jack Operator : Material Handler : Stand Up Forklift Cert : Warehouse-General Shrink - Wrap Machine Operator : Slip Sheet Attachment WELDINGMIG Welder : Aluminum : Tig : Braze / Solder : Fluxcore : Sub - Arc : Spot Weld : Burner Operator : Torch / Cutters : Code : Spray Arc : Heliarc : Fit - Up : Stick : Resistence / Induction : A.W.S. Certified : DRIVERSBus : State Chauffer : Carcass Experience : Type "A" Semi Truck : Route Sales : CDL Class A Commercial Driver's License : Over The Road : Type "B" Straight Truck : Local : DOT Certified : CDL Class B : SHIPPING & RECEIVING UPS Shipping - Online Exp. : Express Mail Shipping Exp. : C.R.T. Exp - Lite Typing : Local Transport Exp. : Freight Weight Exp. : International Transport Exp. : Ship / Receive General : State Transport Exp. : Packing / Sorting : AGRICULTUREDetassling Experience : Drive - Farm Equipment : General Farm Labor : Livestock : WOODWORKINGJack Operator : Topcoat Sander : Spraying Stain : Top Rubber : Material Handler (woodworking) : Structural Steel : Wood Fabricator : Knows Species of Wood Whitewood Inspector : Tenon Machine : Table Saw : Drum Sander : Wiping Stain : Upholsterer : Edge Sander : Spraying Topcoat : Drill Press : Mould Sander : Excavating Eqmnt Operator : Spraying Sealer : Packer / Wood : Top Press : Sealer Sander : Install Hardware : Finish Inspector : Band Saw : Plumber - Journeyman : Offbearer : CNC Router : Glue Wheel : Hand Sander : Trim Nail Operator : Screwdriver Operator : Spraying Lacquer : PRINTINGLaminate Exp Typesetter : Laminating Machine : Web Press Assistant : Embroidery Tech : Digital Equipment Line Sorting : Proofreader : Corrugated Operator Press Operator / Printing : Screen Printing : Folding Machine Oper / Printing : Cutter / Operator : Inserter Operator : Collator Operator : Estimating Bulk Sorting : Press Operator Helper : 2 - Color Process : Bindery Work : 4 - Color Process : OTHER SKILLED Fleet Machine : Stationary Engineer : Electrician - Journeyman : Equipment Operator : Plumber : Overhead Crane Operator CONSTRUCTION Construction - Commercial : Construction - Industrial : Fiberglass: Concrete Worker : Roofing : Crew Leader : Afraid of Heights : Siding Expereience : Drywall Experience : Tower Climbing : Foundation Experience : Masonry : Carpenter : Construction : Residential : PAINTERDip : Roller : Residential : Brush : Industrial : Electro Static : Spray : Commerical : Polish / Buff Finish : Sandblaster : Airless Spray : RETAILCashier-Retail Inventory-Retail Sales-Retail Stocking-Retail MISC. SKILLS (METALS)Metal Fabrication Structural Steel Experience Cold Roll Steel Experience : LAWN MAINT.Fertilized : General Landscaping : MAILROOMBinder Worker Postage Mach Operator Folding Machine Operator Mail-File Sorting Bulk Mail Sorting Mail Clerk Burster Machine Operator MISC.Dry Cleaners Power Tools Bartender Electrical Helper Plumber Helper Laundry Security Guard Greenhouse Worker Health Care Aid TERMS AND CONDITIONS "I understand that if I am offered and accept a job, the company reserves and retains the right to make such changes in the terms and conditions of my employment as the company determines to be necessary or appropriate.""I understand and agree that my future employment is not for any guaranteed length of time and that both the company and I have the freedom to terminate the employment relationship whenever either chooses to do so."APPLICANT'S AUTHORIZATION TO RELEASE INFORMATIONIt is important that each item on this application is correctly and completely answered. False information, misrepresentation or omissions of act, with respect to any part of or item on this application, may be cause for rejection, or for dismissal if employed.While processing my application, I authorize Tower and its Agents to contact schools, employers, references, and organizations to conduct a background investigation, and to obtain a credit report. I further authorize such persons to provide Tower and its Agents with all relevant information necessary to process my application.By choosing "I Agree" and typing my Initials, I affirm that all statements made are true, and misrepresentation of facts will subject me to immediate rejection, or for dismissal if employed. I also consent to a controlled substance screening test and give my consent for all information obtained as a result of any medical examination and all other relevant medical information to be released to Tower and its Agents for the employer's use only.I Agree:*yesInitials:* Submit