Application Form Positions Purchasing/AP Estimator Project Manager Machine Operator Fitter Welder Driver PERSONAL INFORMATION Full Name* Phone* Email* Referred By Present Address Address* City* State* Zip* Permanent Address (if different from above) Address City State Zip EMPLOYMENT DESIRED / GENERAL INFORMATION Position Desired* Date You Can Start* Salary Desired Are you over the age of 18? Please SelectYesNo Are You Currently Employed? Please SelectYesNo If so, may we contact your current employer? Please SelectYesNo Are you legally eligible for employment in the US? Please SelectYesNo Have you ever been convicted of a felony? Please SelectYesNo EDUCATION HISTORY Grammar School Name/Location Subjects Studied Years Attended Graduated? Please SelectYesNo High School Name/Location Subjects Studied Years Attended Graduated? Please SelectYesNo College Name/Location Subjects Studied Years Attended Graduated? Please SelectYesNo Trade, Business or Correspondence School Name/Location Subjects Studied Years Attended Graduated? Please SelectYesNo WORK EXPERIENCE List below last four employers, starting with last one first. Work Experience #1 Employer Name Salary Position Dates of Employment (start date - end date) Reason For Leaving Work Experience #2 Employer Name Salary Position Dates of Employment (start date - end date) Reason For Leaving Work Experience #3 Employer Name Salary Position Dates of Employment (start date - end date) Reason For Leaving Work Experience #4 Employer Name Salary Position Dates of Employment (start date - end date) Reason For Leaving SPECIAL TRAINING/SKILLS Please list any subjects of special study/research work or special training U.S. Military or Naval service Rank REFERENCES Please list below the names of three persons not related to you, whom you have known at least one year. Reference #1 Name Business Address Phone Number Years Known Reference #2 Name Business Address Phone Number Years Known Reference #3 Name Business Address Phone Number Years Known 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 of 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 an authorized company representative. • This waiver does not permit the release of use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I agree to the above statement PRE-EMPLOYMENT DRUG TESTING CONSENT AND RELEASE FORM • I recognize that any offer of employment to me by McWhirter Steel, Inc. is conditional upon my successful completion of a drug test to confirm there are no illegal or unauthorized substances in my system. • I hereby consent to submit to urinalysis and/or tests as shall be determined by McWhirter Steel, Inc. for the purpose of testing for illegal drugs or alcohol. • I further agree to, and hereby authorize the release of, the results of said tests to McWhirter Steel, Inc. • I understand that a positive, confirmed test for illegal drugs or alcohol will prohibit me from being employed with McWhirter Steel, Inc. • I further hold harmless, McWhirter Steel, Inc. and its agents from any liability arising in whole or part out of the collection of specimens, testing, and use of the information from said testing in connection with the organization’s consideration of my employment application. • I further agree that a reproduced copy of this Pre-employment Drug Testing Consent and Release Form shall have the same force and effect as the original. • I have carefully read the preceding information, fully understand its contents, and agree to the aforementioned testing, should I be offered employment with McWhirter Steel, Inc. • I acknowledge that my signing of this Consent and Release Form is a voluntary act on my part, and that I have not been coerced into signing this document by anyone. I agree to the above statement Please attach Resume & Cover Letter here (PDF format only, 3MB max): *Required fields are indicated with an asterisk.You must check the two boxes above to agree to the terms stated in order to submit this form.