Employment Applicant Name* Address* Street Address Address Line 2 City 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 State ZIP Code Email* Phone*Date Available for Work* MM slash DD slash YYYY If employed and under 18, can you furnish a work permit?* yes no Have you ever been employed by Oldenburg Metal Tech, Inc?* yes no Are you employed now?* yes no May we contact your present employer?* yes no If yes, employer contact name* Are you prevented from lawfully becoming employed in this country because of visa or immigration status?* yes no Type of Work Desired* Can you perform the essential functions of the job(s) for which you are applying?* yes no If applying for a position where driving is required, do you have a valid driver’s license in Wisconsin?* yes no License Number* Are you available to work* Full Time Part Time Overtime Have you been convicted of a felony?* yes no Please note that a “Yes” answer will not bar you from consideration for employment EDUCATIONSchool Name and AddressHigh School Years Completed (i.e. 9, 10, 11, or 12)Course of Study Address College Years Completed (i.e. 1, 2, 3 or 4)Course of Study Address Graduate Years Completed (i.e. 1, 2, 3 or 4)Course of Study Address SPECIAL SKILLS, QUALIFICATIONS AND CONSIDERATIONSSummarize special skills and qualifications, volunteer activities, military experience, employment or other activities related to the job you are seeking:Skills EMPLOYMENT EXPERIENCEEmployer* Supervisor Name* Address*Your Position* PhoneDates of Employment* Mo/YrStarting Salary* Ending Salary* Duties*Reason for Leaving* Employer Supervisor Name AddressYour Position PhoneDates of Employment Mo/YrStarting Salary Ending Salary DutiesReason for Leaving Employer Supervisor Name AddressYour Position PhoneDates of Employment Mo/YrStarting Salary Ending Salary DutiesReason for Leaving REFERENCESPlease list (3) non-relatives who are familiar with you qualifications, work history, and ability.Name* Occupation/Relationship* Years Known* Phone*Name* Occupation/Relationship* Years Known* Phone*Name* Occupation/Relationship* Years Known* Phone* PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK THEM BEFORE SIGNING. I certify that all answers and statements I have made on this application (and resume’ or other supplementary materials) are true and complete without omissions. By signing below, I authorize Oldenburg Metal Tech, Inc. to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I understand that any false information provided by me will likely result in a refusal to hire or immediate discharge if I am employed with Oldenburg Metal Tech, Inc. I authorize any of the persons or organizations names in this application to give you complete information and records regarding my employment, education, character and qualifications. If hired I will be responsible for familiarizing myself with all ruled and regulations of Oldenburg Metal Tech, Inc. as they presently exist or are later modified, If hired, I understand my employment can be terminated, at the discretion of Oldenburg Metal Tech, Inc. or at my option I also understand that no representative of Oldenburg Metal Tech, Inc. has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the president of Oldenburg Metal Tech, Inc. I understand this application is not an offer of employment and promises or representations of employment have been made to me at this time. I have read, understand, and agree with the above. Consent* I have read, understand, and agree with the following:PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK THEM BEFORE SIGNING. I certify that all answers and statements I have made on this application (and resume’ or other supplementary materials) are true and complete without omissions. By signing below, I authorize Oldenburg Metal Tech, Inc. to investigate all statements contained in this employment application as they may deem necessary in arriving at an employment decision. I understand that any false information provided by me will likely result in a refusal to hire or immediate discharge if I am employed with Oldenburg Metal Tech, Inc. I authorize any of the persons or organizations names in this application to give you complete information and records regarding my employment, education, character and qualifications. If hired I will be responsible for familiarizing myself with all ruled and regulations of Oldenburg Metal Tech, Inc. as they presently exist or are later modified, If hired, I understand my employment can be terminated, at the discretion of Oldenburg Metal Tech, Inc. or at my option I also understand that no representative of Oldenburg Metal Tech, Inc. has any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits, or terms and conditions of employment, except as specifically stated in a current written agreement signed by the president of Oldenburg Metal Tech, Inc. I understand this application is not an offer of employment and promises or representations of employment have been made to me at this time. Name First Last By checking this box, I acknowledge my electronic signature Date MM slash DD slash YYYY