Job Application

Qualified applicants receive consideration for employment without discrimination because of sex, marital status, race, color, creed, national origin, age, the presence of a disability, or any other basis protected by federal, state or local law.
Conditions of employment are stated at the end of this form. Please read carefully before you sign this application. False statements on this application shall be considered reason for termination.

Attention:
Quadel Industries is a drug-free work place. All new hires will need to pass a preemployment drug test.
Quadel will pay for testing.

Name*
First Last
Present Address*
Street Address City State ZIP Code
Previous Address
Street Address City State ZIP Code
Phone
Position or type of employment desired
Available For
- Full Time
- Part Time
- Temporary
Date Available
MM slash DD slash YYYY
Rate of pay expected
Why would you like to work in plastics manufacturing?
Why are you interested in working for Quadel?
Please describe what type of work you like best
Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodation?
If necessary, can you work evenings, nights, and/or weekends?
Do you have a valid drivers license?
License #
Do you have a Commercial Driver’s License?
If yes, please indicate the nature of offense, date, court & disposition. (A conviction will not necessarily disqualify an applicant from employment)
EDUCATION
High School
School Name & Address
Major Subject
Graduate?
Give Degree
College
School Name & Address
Major Subject
Graduate?
Give Degree
Business, Trade, Other
School Name & Address
Dates Attended From/To
Major Subject
Graduate?
Give Degree
Do you plan to further your education?
If yes, please explain
SKILLS
Select your skills
- Select All
- Mechanical
- Power Tools
- Change Tires
- Change Oil
- Pull Motor
- Rebuild Motor
EMPLOYMENT HISTORY
List previous employers starting with most recent
(1) Company Name & Address
Employed from
to
Position start
last
Name & Title of Immediate Supervisor
Main Duties
Reason for leaving
Phone
(2) Company Name & Address
Employed from
to
Position start
last
Name & Title of Immediate Supervisor
Main Duties
Reason for leaving
Phone
(3) Company Name & Address
Employed from
to
Position start
last
Name & Title of Immediate Supervisor
Main Duties
Reason for leaving
Phone
List periods of unemployment for more than 30 days
Date from
to
Explain
Date from
to
Explain
PLEASE NOTE
Applicant agrees to the following conditions of employment: If hired, I will receive a copy of the Quadel Employee Handbook and agree to fully and completely read it. I understand that neither this handbook nor any other communication by a management representative is intended to, in any way, create a contract of permanent employment or employment for a specified time. I further understand that my employment can be terminated at any time, with or without cause, and with or without notice, at the option of either the company or myself. I swear all statements in this application are true and correct. If any information is false, it will be cause for termination. I understand employment is contingent upon verification of identity to work in the United States. I certify that the information given by me to Quadel is true and complete to the best of my knowledge. I further certify that I am not engaged in any outside activity or business that could be considered in conflict with Quadel’s interest or those of its customers, nor will I become engaged in such activity or business if employed. If employed, I further agree that if during the course of my employment Quadel advances any paid leave to me before it has been earned or accrued, overpays me, or advances or loans me any money, or if through my dishonest or willful act, I lose, damage or fail to return any of Quadel’s property, my signature on this application is my authorization to Quadel to deduct from my wages or any other amounts Quadel may owe me, sufficient funds to repay what I owe Quadel or to replace Quadel’s property. If a conditional job is offered to me, I will be required to submit to a drug and alcohol test within 24 hours after being notified. Quadel actively and proudly promotes a safe, Drug and Alcohol free workplace. As a condition of employment all employees are subject to random drug and alcohol testing, post accident drug and alcohol testing and reasonable suspicion drug and alcohol testing. I hereby authorize Quadel to solicit information regarding my credit history and previous employment. I release all parties and persons connected with such solicitation from all claims, liabilities, and damages for any reason arising out of the furnishing of such information. 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.