Online Employment Application

Personal Information

Full Name:*

First

Last

Current Address:*

Street AddressCityState / Province / RegionPostal / Zip Code

Phone:*

Area Code

-

Phone Number

Secondary Phone:

Area Code

-

Phone Number

E-mail:*

Attach Resume (5MB Limit):

How did you hear about us?*

Name of Employee:*

First

Last

Name of Individual:*

First

Last

Brief Explanation:*

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Employment Desired

Position Desired:*

When Can You Start:*

Are You Currently Employed?*

Yes

No

May We Contact Your Current Employer?*

Yes

No

Current Employer:*

Salary Desired:*

Have You Ever Applied Here Before?*

Yes

No

What Position?*

What Date?*

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Education History

Grammar School:

High School:

College:

Trade, Business Or Correspondence School:

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General Information

Subjects of Special Study or Research Work

Special Skills:

Activities (Civic, Athletic, Ect.)

U.S. Military Or Naval Service

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Previous Employers

Employer #1:

Company Name (Employer 1):

Phone Number (Employer 1):

Area Code

-

Phone Number

From Date (Employer 1)::

To Date (Employer 1):

Salary (Employer 1):

Position (Employer 1):

Reason For Leaving (Employer 1):

Employer #2

Company Name (Employer 2):

Phone Number (Employer 2):

Area Code

-

Phone Number

From Date (Employer 2):

To Date (Employer 2):

Salary (Employer 2):

Position (Employer 2):

Reason For Leaving (Employer 2):

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References

Reference #1:

Reference #2:

Reference #3:

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In Case Of Emergency Notify

ICE Contact Name:*

First

Last

ICE Contact Address:*

Street AddressCityState / Province / RegionPostal / Zip Code

Relation to Applicant: *

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Authorization

“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED,

FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL

INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE

COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION.

I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY

SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AND AUTHORIZED COMPANY

REPRESENTATIVE.

THIS WAIVER DOES NOT PERMIT THE RELEASE OR USE OF DISABILITY-RELATED OR MEDICAL INFORMATION IN A MANNER PROHIBITED BY THE AMERICAN WITH

DISABILITIES ACT (ADA) AND OTHER RELEVANT FEDERAL AND STATE LAWS.

I HEREBY ACKNOWLEDGE THAT I HAVE BEEN INFORMED BY DIAMOND MANUFACTURING OF BLUFFTON THAT DIAMOND MANUFACTURING OF BLUFFTON MAY SEEK TO

OBTAIN A CONSUMER REPORT AND/OR INVESTIGATIVE REPORT THAT WILL INCLUDE PERSONAL INFORMATION REGARDING ME, INCLUDING BUT NOT LIMITED TO,

EDUCATIONAL HISTORY, WORK REFERENCES, DRIVING RECORD AND CRIMINAL CONVICTIONS OR ARREST RECORDS, IN ORDER TO ASSIST DIAMOND

MANUFACTURING OF BLUFFTON IN MAKING EMPLOYMENT DECISIONS.

I FURTHER ACKNOWLEDGE BY DIAMOND MANUFACTURING OF BLUFFTON THAT REPORTS MAY BE PROVIDED TO DMB BY OTHER FIRMS CONTRACTED FOR THAT

PURPOSE. I, MY HEIRS, ASSIGNS, AND LEGAL REPRESENTATIVES, HEREBY RELEASE AND FULLY DISCHARGE DIAMOND MANUFACTURING OF BLUFFTON FROM ANY

AND ALL CLAIMS MONETARY OR OTHERWISE, THAT I MAY HAVE AGAINST DMB, ARISING OUT OF THE MAKING, OR USE OF, EITHER A CONSUMER REPORT AND/OR

INVESTIGATIVE REPORT, INCLUDING ANY ERRORS OR OMISSIONS CONTAINED OR OMITTED FROM SUCH REPORTS.

DIAMOND MANUFACTURING OF BLUFFTON AGREES TO INFORM APPLICANT IF AN EMPLOYMENT DECISION HAS BEEN INFLUENCED BY INFORMATION CONTAINED IN A CONSUMER OR CRIMINAL HISTORY REPORT. APPLICANT MAY OBTAIN A FREE COPY OF THE REPORT WITHIN 60 DAYS BY CONTACTING DIAMOND MANUFACTURING OF BLUFFTON IN WRITING. A SUMMARY OF “YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT” IS ON THE ATTACHED FORM.”

IN COMPLIANCE WITH FEDERAL LAW, ALL PERSONS HIRED WILL BE REQUIRED TO VERIFY IDENTITY AND ELIGIBILITY TO WORK IN THE UNITED STATES AND TO

COMPLETE THE REQUIRED EMPLOYMENT ELIGIBILITY VERIFICATION DOCUMENT FORM UPON HIRE.

I Acknowledge that the Information in this Application is True to the best of my Knowledge:*

Accepted

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THANK YOU!!

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