Cage Code: 9DGX2

CNC Machining/Fabrication

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IMR Job Application

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Job Applying For

First Name

Last Name

Street Address

City

State

Email

Phone

Date Available

Date of Birth

Are you a citizen of the United States?

Yes

No

Have you ever worked for this company?

Yes

No

Have you ever been convicted of a felony?

Yes

No

If no, are you authorized to work in the U.S.?

Yes

No

If yes, when?

Yes

No

If yes, explain:

Education

High School

High School Address

To:

From:

Did you graduate?

Yes

No

Diploma:

College

College Address

To:

From:

Did you graduate?

Yes

No

Degree:

Other

Other Address

To:

From:

Did you graduate?

Yes

No

Degree:

References
Please list three professional references

Reference 1

Reference 1 Address

Reference 1 Company

Reference 1 Phone

Reference 1 Relationship

Reference 2

Reference 2 Address

Reference 2 Company

Reference 2 Phone

Reference 2 Relationship

Reference 3

Reference 3 Company

Reference 3 Address

Reference 3 Phone

Reference 3 Relationship

Previous Employment

Company 1

Company 1 Address

Company 1 Phone

Company 1 Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities:

To:

From:

May we contact your previous supervisor?

Yes

No

Reason for leaving:

Company 2

Company 2 Address

Company 2 Phone

Company 2 Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities:

To:

From:

May we contact your previous supervisor?

Yes

No

Reason for leaving:

Company 3

Company 3 Address

Company 3 Phone

Company 3 Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities:

To:

From:

May we contact your previous supervisor?

Yes

No

Reason for leaving:

Military Service

Branch

From:

To:

Rank at Discharge

Type of Discharge

If other than honorable, explain:

Terms and Conditions

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

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IMR Inc.

Cage Code: 9DGX2

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