Northern Gear & Machine LLC
W160 S6609 Commerce Drive
Muskego, WI 53150
Phone: 414.423.9460
Fax: 414.423.7805
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Application For Employment

We consider applications for all positions without regard to race, color, religion, creed, sex, national origin,
disability, sexual orientation, citizenship status or any other legally protected status.


How Did You Learn About Us Advertisement Relative Inquiry
Employment Agency Friend Other

Contact Info

If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes  No 
Have you ever filed an application with us before? Yes  No 
          
Have you ever been employed with us before? Yes  No 
 
Do any of your friends or relatives, other than spouse, work here? Yes  No 
Are you currently employed? Yes  No 
May we contact your present employer? Yes  No 
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status
Proof of citizenship or immigration status will be required upon employment
Yes  No 
Are you available to work:
  Full-Time please indicate shift 1      2      3  
  Part-Time please indicate Mornings      Afternoon      Evenings  
  Temporary please indicate dates available  
Are you currently on "lay-off" status and subject to recall? Yes  No 
Can you travel if a job requires it? Yes  No 

EDUCATION

  Name and Address
of School
Course of Study Number
of Years
Completed
Diploma
Degree
Undergraduate
College

Employment Experience

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You . may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status.

1 Dates Employed Work Performed
From To
Supervisor Hourly Rate
or Salary
Reason for Leaving Starting Final

2 Dates Employed Work Performed
From To
Supervisor Hourly Rate
or Salary
Reason for Leaving Starting Final

3 Dates Employed Work Performed
From To
Supervisor Hourly Rate
or Salary
Reason for Leaving Starting Final

4 Dates Employed Work Performed
From To
Supervisor Hourly Rate
or Salary
Reason for Leaving Starting Final

List professional, trade, business or civic activities and offices held.

You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status:

Additional Information

Other Qualifications

Summarize special job-related skills and qualifications acquired from employment or other experience.

Specialized Skills

(Check Skills / Equipment Operated)

Terminal
PC/MAC
Typewriter
Spreadsheet
Word Processing
Shorthand
Production / Mobile Machinery (list) Other (list)
State any additional information you feel may be helpful to us in considering your application
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Can you perform the essential functions of the job, for which you are applying, either with or without a reasonable accommodation? Yes  No 

References

1 Name Phone
Address

2 Name Phone
Address

Name Phone
Address

Applicant's Statement

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

By checking this box and submitting this application, I agree to the above statement.

 
 

Questions or comments?

Please contact our HR Department:

HR Manager, 414-423-9460
HR@NorthernGear.com
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