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JADCO Manufacturing, Inc. is an Equal Opportunity Employer. Employment offers are made on the basis of qualifications and without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.

To submit your application please complete the form below. Fields marked with an asterisk * are required. When you have finished click Submit at the bottom of this form.

Name

Other names under which you have attended school or been employed

Miscellaneous

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Are you 18 years of age or older?*

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Have you ever been employed by JADCO?*

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If YES, dates of employment & reason for leaving

Are you willing to work overtime, on different shifts, and weekends when necessary?*

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If No, please explain:

Are you related to any current JADCO employee(s)?*

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If YES, what are their names & their relationships to you?

If required for position, do you have a valid driver's license?*

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If YES, State of issuance, license # and expiration date

Do you have access to adequate transportation to and from work?*

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If No, please explain:

Have you ever served in the Armed Forces?*

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If Yes, which branch:

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How did you learn about this employment opportunity at JADCO? Check all that apply*

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Level of Education*

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Name of School - High School*

City / State*

Did you graduate or acquire a GED?*

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If YES, date of graduation

Name of School - Other School (Trade or Technical)

City / State

Did you graduate?

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If YES, date of graduation

Degree received

Major

Name of School - College or University

City / State

Did you graduate?

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If YES, date of graduation

Degree received

Major

Other credentials / licenses / professional affiliations, etc., which are relevant to the job(s) for which you are applying

Dates Employed (most recent position)*

Are you still employed at this location?*

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Organization Name and Address*

Full Time / Part Time*

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If part-time, # hours / week

Title*

Salary*

Primary duties*

Reason for leaving*

Supervisor's Name, title and Phone #*

Dates Employed (Job Details #2)

Organization Name and Address

Full Time / Part Time

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If part-time, # hours / week

Title

Salary

Primary Duties

Reason for leaving

Supervisor's Name, title and Phone #

Dates Employed (Job Details #3)

Organization Name and Address

Full Time / Part Time

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If part-time, # hours / week

Title

Primary Duties

Reason for leaving

Supervisor's Name, title and Phone #

Reference 1*

Reference 2*

Reference 3

Upload your resume*

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I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date.

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I authorize Jadco Manufacturing, Inc., to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment.

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If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment.

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I understand that this document is not an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that employees of JADCO Manufacturing, Inc., serve at-willl, and the employment relationship may be terminated at any time by either party, for any or no reason, other than a reason prohibited by law.

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If employed, I will be required to furnish proof of eligibility to work in the United States and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off.

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I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice.

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I certify that all information in this application is true and correct as of date mentioned.

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Please type first and last name as your signature and affirmative response to this statement.

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eSignature

Date: