Employment Application | Curtis Products, Inc

Thank you for expressing an interest in employment with Curtis Products, Inc.

Curtis Products, Inc. is an Equal Opportunity Employer, offering job opportunities and advancement on an equal basis to all qualified persons regardless of race, sex, religion, age color, national origin, citizenship status, physical or even mental disability, or veteran status.

This application is effective for one year from the date of application. If you are still available after that time, you must reapply. Failure to fully complete this application may result in non-consideration.
Fields marked with an asterisk (*) are required.
Date
Name*
First Middle Last
Current Address*
Street Address City State ZIP Code
Daytime Phone*
Position Applied For (Only list one position)
Name of person who referred you (If applicable)
Type of Work Desired*
- Full-Time
- Part-Time
Shift Desired*
- First Shift
- Second Shift
High School
Name*
Did you graduate?*
- Yes
- No
Degree/Diploma/Certificate
Grade Point Average
Major Course of Study
Technical, Vocational, Business Training
Name
Did you graduate?
- Yes
- No
Degree/Diploma/Certificate
Grade Point Average
Major Course of Study
College or University
Name
Did you graduate?
- Yes
- No
Degree/Diploma/Certificate
Grade Point Average
Major Course of Study
Additional Educational Experiences
Employment History
1. Present Employer or Most Recent Employer
Company Name
Phone Number
Street Address City State ZIP Code
Supervisor Name
Dates of Employment
From Date
Date Format: MM slash DD slash YYYY
To Date
Date Format: MM slash DD slash YYYY
Salary
From
To
Job Titles & Duties
Reason For Leaving
May we contact this employer?
- Yes
- No
2. Former Employer
Company Name
Phone Number
Street Address City State ZIP Code
Supervisor Name
Dates of Employment
From Date
Date Format: MM slash DD slash YYYY
To Date
Date Format: MM slash DD slash YYYY
Salary
From
To
Job Titles & Duties
Reason For Leaving
May we contact this employer?
- Yes
- No
3. Former Employer
Company Name
Phone Number
Street Address City State ZIP Code
Supervisor Name
Dates of Employment
From Date
Date Format: MM slash DD slash YYYY
To Date
Date Format: MM slash DD slash YYYY
Salary
From
To
Job Titles & Duties
Reason For Leaving
May we contact this employer?
- Yes
- No
Other Job Related Experience
Some people gain job related experience in positions other than as an employee. For instance, a manager may gain experience while working on civil projects, in school organizations or in PTA activities. Please list and describe any paid or unpaid activities, honors, experience, or training which might aid you in performing the job(s) for which you may have applied, and have not listed previously in this application. (You may omit any activities, honors, or other items that tend to identify your race, sex, religion, national origin, age, disability, or other personal traits that you prefer not to disclose.)
Additional Information
Please add any additional information (except, at your option, that which identifies your race, sex, religion, national origin, age, disability, or other non-job-related personal information) that you think may be relevant to the decision to hire you.
Periods of Unemployment
Please account for any time you were not employed after leaving school in the past 10 years. (You need not list any unemployment periods of six weeks or less).
General Information
1. Have you ever applied for a job with this company in the past?*
- Yes
- No
If yes, date that you applied
Date Format: MM slash DD slash YYYY
Name on the application
First Last
Position applied For
2. Has this company ever employed you in the past?*
- Yes
- No
If yes, dates of employment
From Date
Date Format: MM slash DD slash YYYY
To Date
Date Format: MM slash DD slash YYYY
Name while employed (If different from your present name)
First Last
Position(s) held during previous employment
Reason you left
If hired, will you be able to work the scheduled days and hours required for the position(s) for which you are applying?*
- Yes
- No
If hired, can you furnish proof that you are at least 18 years of age?*
- Yes
- No
If no, please explain
Do you have any commitments to another employer that might affect your employment with our company?*
- Yes
- No
If yes, please explain
If hired, can you furnish proof that you are eligible to work in the United States? (If unsure of the documents needed to prove eligibility to work in the U.S. , we will be happy to explain the legal requirements).*
- Yes
- No
If no, please explain
Please read carefully and initial each paragraph before signing.
By my signature and initials placed below, I certify that the information provided in this employment application (and accompanying resume, if any) is true and complete, and I understand that any false information or significant omissions may disqualify me from further consideration for employment, and may be justification for my dismissal from employment, if discovered at a later date.
I authorize any person, school, current employer, past employer(s), and organizations named in this application form (and accompanying resume, if any) to provide this company with relevant information and opinions that may be useful to the company in making a hiring decision, and I release such persons and organizations from any legal liability in making such statements.
Initials*
A drug test and criminal background check will be required. I understand that any offer of employment may be withdrawn if I test positive for drugs and/or if a condition is discovered for which no reasonable accommodation can be made.
Initials*
I understand that neither this application nor any other offer of employment, which results, creates nor is intended to create a contract of employment. I understand that, if hired, my employment is for no definite period of time and may be terminated at any time, with or without cause and with or without notice. I also understand that no person is authorized to change any of the terms mentioned in this employment application from except the President. Any such change, to be valid, must be in writing and signed by him/her.
Initials*
Full Name*
Date*
PLEASE REVIEW YOUR APPLICATION AND ENSURE ALL INFORMATION IS CORRECT
CAPTCHA

High School

Technical, Vocational, Business Training

College or University

Employment History

General Information