Anchor Plastics, Inc.

Full Name:

Address:

City, State, ZIP:

Phone Number:

Email Address:

Desired Position:

Attach your resume here:

Are you able to lift 55lbs minimum?

Yes
No

Date Available for Work (MM/DD/YYYY):

Full time or Part time?

Full time
Part time

Preferred Shift:

First
Second

Are you willing to work a different shift than what you have selected?

Yes
No

Have you worked for Anchor Plastics before?

Yes
No

If yes, when?

Can you provide proof that you are legally eligible to work in the U.S.?

Yes
No

Do you have a valid driver's license?

Yes
No

Did you graduate High School or have a GED equivalent?

Yes
No

What was your final Grade Point Average?

What was the name, city and state of the high school you attended?

Do you have any post high school experiences that may set you apart from other applicants?

Yes
No

If yes, please describe them in detail and note any certificates or degrees that were obtained:

Have you ever served in the military?

Yes
No

If yes, what type of education and training did you receive?

Work Experience
Company #1:

Position held and your responsibilities for that position:

Dates of employment (MM/YYYY-MM/YYYY):

Company #2:

Position held and your responsibilities for that position:

Dates of employment (MM/YYYY-MM/YYYY):

Company #3:

Position held and your responsibilities for that position:

Dates of employment (MM/YYYY-MM/YYYY):

Please type your full name as an electronic agreement for the following:

1) That you authorize investigation of all statements contained in this application, including work experience and educational background;

2) That you understand that if selected for employment, misrepresentation or omission of facts called for is cause for dismissal, and;

3) That you understand that your employment is for no definite period of time and that you may be terminated at any time without any previous notice:

Today's Date (MM/DD/YYYY):

What makes you the perfect candidate for this position?

How did you hear about us?