Apply Online Fields marked with an * are required Step 1 of 6 – GENERAL 16% GENERAL INFORMATIONName* First Middle Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Contact Number*Email* Are you legally authorized to work in the United States?*Please select oneYesNoDo you now, or will you in the future, require immigration sponsorship for work authorization (e.g., H-1B)?*(If hired, verification will be required consistent with federal laws.)Please select oneYesNo POSITION INFORMATIONType of position:* Factory Office Seasonal Preferred shift? Any 1st 2nd 3rd Position applied for:Salary Negotiable I have a desired salary range Salary/hourly range expected:*Per:*Please select oneper yearper hourHave you worked for The Wooster Brush Company before?*Please select oneNoYesWhat was your position?*BACKGROUND INFORMATIONDuring the past seven years, have you ever been discharged, suspended, or asked to resign from any position?*Please select oneNoYesPlease explain*For the purpose of verifying information on this application, have you ever worked or attended school under a different name at any of the organizations you have listed?*Please select oneNoYesSpecify different name used*Have you ever been convicted of a crime (not traffic violations) that has not been expunged, sealed, pardoned, annulled, statutorily eradicated, or dismissed upon condition of probation? (Please note: You are not required to disclose sealed or expunged records of conviction or arrest or expunged juvenile records of conviction or arrest.)*Please select oneNoYesPlease explain* EDUCATION INFORMATIONHIGH SCHOOL OR GED EQUIVALENTSchool Name & Location*Highest Grade Completed*Please select one8th Grade9th Grade10th Grade11th Grade12th GradeGEDNot ApplicableCOLLEGE OR UNIVERSITYSchool Name & LocationDegreePlease select oneDid not graduateAssociatesBachelorsMajorGRADUATE SCHOOLSchool Name & LocationDegreePlease select oneDid not graduateMastersDoctorateCourse of StudyOTHER (INCLUDING MILITARY TRAINING)Please provide detailsPlease comment on any specific experiences, skills, or licenses you have that you feel qualify you for employment with our Company EMPLOYMENT HISTORYList all employment experience for the past seven years, starting with the most recent or present employer, including U.S. Military Service. Using a separate section for each position, describe in detail all work experience including periods of unemployment. Please note: you may include, as part of your employment history, any verified work performed on a volunteer basis. Resumes may not be substituted in lieu of completing the following employment information.POSITION 1:Current Employer This is my current employer Employer*Job Location*Your Position*Supervisor's Name/Title*May we contact your supervisor?*Please select oneYesNoWhy?*Primary Responsibilities*Employer Phone*Start Date:* MM slash DD slash YYYY End Date:* MM slash DD slash YYYY Starting RateLast RateReason for leaving*POSITION 2:EmployerJob LocationYour PositionSupervisor's Name/TitleMay we contact your supervisor?Please select oneYesNoWhy?Primary ResponsibilitiesEmployer PhoneStart Date: MM slash DD slash YYYY End Date: MM slash DD slash YYYY Starting RateLast RateReason for leavingPOSITION 3:EmployerJob LocationYour PositionSupervisor's Name/TitleMay we contact your supervisor?Please select oneYesNoWhy?Primary ResponsibilitiesEmployer PhoneStart Date: MM slash DD slash YYYY End Date: MM slash DD slash YYYY Starting RateLast RateReason for leavingHave you signed or otherwise agreed to any non-solicitation, non-competition, or other similar agreement with any prior employer?*Please select oneYesNoPlease explain*Please explain any gaps in employment PERSONAL REFERENCESList three references (not relatives) that we may contact:REFERENCE 1:Name*Relationship*Phone*Email REFERENCE 2:Name*Relationship*Phone*Email REFERENCE 3:Name*Relationship*Phone*Email Please list any relatives or friends that work, or have worked, at The Wooster Brush Company: PLEASE READ CAREFULLY BEFORE SUBMITTINGTerms and Conditions*I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment. I understand an offer of employment may be subject to and conditioned upon a satisfactory background check, pre-employment physical exam, and a drug and alcohol test. I hereby certify that the information given by me is true and complete, and I understand that any falsification or omission of information may disqualify me from further consideration for employment, or if hired, may result in termination regardless of the time elapsed before discovery. I authorize The Wooster Brush Company and its representatives to contact my prior employers and all others (with the exception of my current employer, if I selected no in response to may we contact) for the purposes of verification of the information I have supplied and release the same from any liability resulting from the information released. I authorize employers, schools, and other persons named on this application to provide any information or transcripts requested. I hereby certify that, if employed, my employment with The Wooster Brush Company will not conflict with, or result in the violation of, breach of, or default under any contract, agreement, or understanding that I am a party to or am bound by, other than those I have disclosed in this application. I hereby certify that, if employed, I will promptly report to my supervisor, a representative of Human Resources, or other member of management, if I ever believe that I have been harassed in violation of Company policy or if I ever become aware of any unethical behavior by an employee. I expressly understand and agree that, if employed, my employment, having no specific term, is based upon mutual consent and may be terminated at will, with or without cause, by either party without prior notice to the other, unless otherwise prohibited by law. I understand that no representation, whether oral or written, by any representative or agent of The Wooster Brush Company, at any time, can constitute an implied or express contract of employment. I further understand no representative or agent of The Wooster Brush Company has the authority to enter into an agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other terms of conditions of employment other than in a document signed by the President of the Company or an authorized representative and myself. I HAVE READ AND AGREE WITH THE ABOVE STATEMENTS.*
