This Information will be kept confidentially in our file for employment. 
This information will not be shared with any affiliates.
Check all Boxes that apply. Mak Milling is a equal opportunity employer.

PERSONAL:

Name:

Email:

Phone #:

Date Available:

Position Apllied for:

Desired Salary:

Referred by:

Education::

Elementary Junior High GED High School College Masters PhD

DRIVER INFO:

Check Box for true: 

My drivers License is valid.

Driver License #:

Driver Lic Expiration:

Driver License State:

AK - Alaska AL - Alabama AR - Arkansas AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - Washington DC DE - Delaware FL - Florida GA - Georgia HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MI - Michigan MN - Minnesota MO - Missouri MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming Not USA

Driver License Class:

Driver Lic. Exemptions:

List Traffic Convictions,
Last Three Years:

EXPERIENCE:

List Job Related Skills:

List Equipment Operated:

REFERENCES:

List three references that we may contact.

Name
Past Employer
Phone #:

Name
Relationship
Phone#:

Name
Relationship
Phone#:

QUALIFYING ESSENTIAL FUNCTIONS:

Check Boxes as true statement, all that apply.

I am over 18 years old.

I can work out of town with overnight stays.

I can stand or walk for a 12 hour shift.

I can operate machinery for an 12 hour shift.

I can work in extreme weather conditions.

I can grip & hold objects firmly.

I can squat, kneel, climb stairs & ladders.

I can lift objects over 100 pounds.

I can see distances, colors & in dim light.

I can hear safety alarms, warnings & sirens.

I can work around moving machinery.

I can work in confined spaces.

I am a US Citizen.

I have never been Convicted of a Felony.

I can provide 2 forms of ID to show legal right to work.

WORKERS COMPENSATION:

I authorize my Workers Compensation History to be Released to Mak Milling.

Security Code: *

  Enter the numbers from the fuzzy box.

Print application then click the Submit button.