All fields with an " * " are required.

Basic Information

First Name *
Last Name *

Email *
Phone *

Street Address *
City *
State *
Zip *

How long have you lived at the above address?

What type of job are you seeking? *
Full TimePart TimeTemporaryAny
If you were referred to us please list the individual or organization.

Position(s) you are applying for *
Date you can start

Education

Level

High School *

College/University *

Business, Trade, or Military (specify) *

School/Organization

Graduate?

YESNO
YESNON/A
YESNON/A

Skills/Experience

Check kinds of work in which you have had Experience *
AccountingData ProcessingOffice PracticesBuilding Material SalesBookkeepingTruck DrivingBuilding Material PurchasingInsideCashierForklift OperatorYardOutsideCredit & CollectionsBuilding Material Mgmt.WarehouseManagementNone of the above

List the office Skills and/or plant shop machines you are qualified to operate:
1
2
3

4
5
6

Do You Have Your Valid Driver's License? *
YESNO

Has your license ever been suspended or revoked? *
How many convictions for moving violations within past 3 years? *

If employed, are you willing to take a physical examination at company expense? *
YESNO
Do you agree to take random drug test if employed? *
YESNO

Are you willing to take a pre employment drug screen at our expense? *
YESNO
Have you ever applied to this company before? *
YESNO

Have you ever been employed by SLM? *
YESNO
If YES list Dates

to

Past Employment

LIST PREVIOUS EMPLOYERS, STARTING WITH MOST RECENT

NAME OF EMPLOYER *

PHONE # *

SALARY *

Dates *

to
to
to

REASON FOR LEAVING *

May we contact your past & present employers? *
YESNO
Attach Resume

Are you currently employed *
YESNO
If YES where

As an applicant for employment with this company, I understand the following:

  • Any misrepresentation or falsification of information or significant omissions will be cause for rejection of my application or for subsequent discipline up to and including my dismissal from employment if discovered at a later date.
  • My employment is NOt guaranteed for any term, and my employment may be terminated by the company or myself at any time and for any reason. NO management official is authorized to make any oral assurance or promise of continued employment.
  • I authorize and consent to my current and prior employers, educational institutions and persons or organizations named in this application (or accompanying resume) to release any information that may be required to make an employment decision.
  • My employment is contingent upon the results of a drug screening analysis for substance abuse. The results of such analysis may be grounds for disqualifying me or terminating my employment.
  • If I am employed, I agree to comply with and be bound by the safety and health rules and regulations of conduct of the company.
Signature
Date