General Application

Job Application

I certify that the statements on this application are accurate and complete to the best of my knowledge, and I understand that I am subject to dismissal if any information provided by me is false, no matter when discovered. I agree to abide by the policies and rules that HITACHI POWDERED METALS (USA), INC. I understand that if employed, I will be an employee "at will" and that my employment, benefits, and compensation can be terminated, with or without cause, and without notice, at the request of either the Company or myself. I further understand that the policies and practices of the Company do not constitute an employment contact. Finally, I understand that no employee or representative of HPMA has the authority to enter into any agreement or to contract for employment.

I, , authorize HITACHI POWDERED METALS (USA), INC. (aka HPMA) to contact the following previous employers to obtain information regarding my attendance, performance, and possibly disciplinary actions while employed. I agree to release, waive, discharge, and hold harmless HPMA, its employees, and officers from any and all liability for damage that could arise based on information HPMA receives which is determined to be unfavorable, without regard to where that information is true and accurate.

Reference 1: Enter Name

Phone Number: Enter Number

Occupation & Name of Employer: Enter Occupation and Employer

Years Known: Enter Years

E-Mail Address: Enter E-Mail

Reference 2: Enter Name

Occupation & Name of Employer: Enter Occupation and Employer

Years Known: Enter Years

Phone Number: Enter Number

E-Mail Address: Enter E-Mail

Reference 3: Enter Text

Occupation & Name of Employer: Enter Text

Years Known: Enter Years

Phone Number: Enter Number

E-Mail Address: Enter E-Mail

Full Name (Last, First, Middle): Enter Name

Email Address: Enter E-Mail

Current Address: Enter Address

City: Enter City

State: Enter State

Zip code: Enter Zip

Country: Enter Country

Submitting Form...

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Form received.

Do you have transportation?

Yes

Daily Overtime?

Yes

Weekend Overtime?

Yes

Travel?

Yes

High School: Enter School Name

College or University Enter School Name

Graduate/Technical School: Enter School Name

Years Completed: Enter Text

Graduated?

Yes

Graduated?

Yes

Graduated?

Yes

Course or Degree: Enter Course/Degree

Dates Attended (Start - Finish) mm/yyyy: Enter Dates mm/yyyy - mm/yyyy

Required

Dates Attended (Start - Finish) mm/yyyy: Enter Dates mm/yyyy - mm/yyyy

Date dd/mm/yyyy: Enter Date

Position Desired: Enter Position

Salary Requirements: Enter Salary Requirements

Other work interests: Enter Work Interests

Experience, skills, training, or other qualifications that make you suitable for this position: Enter Your Qualifications

Employer 1: Enter Employer Name

Job Title: Enter Job Title

Immediate Supervisor: Enter Supervisor Name

Brief Description of Duties: Enter Description of Duties

Employer Address Enter Employer Address

Employer Phone Number: Enter Employer Number

Start Date: Enter Date mm/yyyy

End Date: Enter Date mm/yyyy

Reason for leaving: Enter Reason for Leaving

Start Wage/Salary: Enter Start Wage

Final Wage/Salary: Enter Final Wage

Current Employer?

Yes

What did you like most about this job? Enter Your Response

What did you like least about your job? Enter Your Response

Account for period between jobs: Enter Your Response

Job Title: Enter Text

Immediate Supervisor: Enter Supervisor Name

Employer 2: Enter Employer Name

Employer Phone Number: Enter Employer Number

Start Date: Enter Date mm/yyyy

End Date: Enter Date mm/yyyy

Employer Address: Enter Employer Address

Brief Description of Duties: Enter Description of Duties

Start Wage/Salary: Enter Start Wage

Final Wage/Salary: Enter Final Wage

Reason for leaving: Enter Reason for Leaving

What did you like most about this job? Enter Your Response

What did you like lease about your job? Enter Your Response

Account for period between job: Enter Your Response

Job Title: Enter Job Title

Employer 3: Enter Employer Name

Start Date: Enter mm/yyyy

End Date: Enter mm/yyyy

Employer 4: Enter Employer Name

Job Title: Enter Job Title

Start Date: Enter mm/yyyy

End Date: Enter mm/yyyy

Employer 5: Enter Employer Name

Hire-Tech Courses?

Yes

Service Start: Enter mm/yyyy

Selective Service Classification: Enter Class

Reserve Status:

Non-member

Inactive

Active

R.O.T.C.

Service End:: Enter mm/yyyy

Branch: Enter Branch

Final Rank: Enter Rank

Organization 1: Enter Name & Address of Organization

Offices Held: Enter Offices Held

Type Enter Type

Special Training in Service: Enter Special Training

Organization 2: Enter Name & Address of Organization

Organization 3: Enter Name & Address of Organization

Type: Enter Type

Offices Held: Enter Office Held

Type: Enter Type

Offices Held: Enter Offices Held

If yes, explain: Enter Your Response

If yes, give details on: (1) Nature of felony charge(s); (2) Date(s) of conviction. Enter Your Response

Job Title: Enter Job Title

Start Date: Enter mm/yyyy

End Date: Enter mm/yyyy

If no, explain restrictions: Enter Travel Restrictions

Previous employment/application with STI or HPMA?

Yes

Have you been convicted of a felony within the past 5 years?

Yes

Do you have any criminal charges pending against you?

Yes

If yes, explain Enter Your Response

Availability for shift:

First Shift

Second Shift

Third Shift

Next Recent Employer Name: Enter Employer Name

Most Recent Employer Name: Enter Employer Name

Next Recent Employer Name: Enter Employer Name

Enter Your Full Name

Applicant's E-Signature: Enter Full Name

Date: Enter dd/mm/yyyy

Phone Number: Enter Number

Desired Position: Enter Position

Education History

Personal Information

Work Interests

Employment History

United States Military Service

Organization Membership

List membership in any community, professional, or trade organizations in which you have has a leadership role. (You my exclude memberships that reveal race, color, religion, national origin, disability, genetics, age, or sex.)

References

Security

Criminal convictions are not an absolute bar to employment, but will be considered in relation to specific job requirements.

Please list three persons, not relatives, who could provide information on your background.

INFORMATION RELEASE FROM PREVIOUS EMPLOYERS

AGREEMENT & RELEASE

Hitachi Powdered Metals (USA), Inc. is an Equal Opportunity Employer

All applicants will be kept on file for 6 months.

ATTENTION: Please send a copy of your resume to: jobs@hitachi-pm.us