Application for Employment

Incomplete applications will be discarded upon receipt. Applications are kept on file with Human Resources for 12 months. Make application follow-up requests IN WRITING ONLY to: Human Resource Manager, P.O. Box 758, Tiffin, OH 44883.

QT2 is an equal opportunity employer. Prospective employees will receive consideration without discrimination based on race, creed, color, sex, age, national origin, handicap, veteran status or any condition prescribed by state or local law.

 

 

PERSONAL INFORMATION

Last Name First Name MI Social Security #
Current Street Address City State Zip
Home telephone number Alternate telephone number
E-Mail address
Maiden Name  (if applicable)

 

 

Job Interest

Status Desired: As Needed (On Call) Full Time (25-40 hrs per week) Part Time (8-24 hrs per week)
(check all that apply)      
Pay Requirements   Per: Hour Week Annual Salary
Are you able/willing to work overtime if asked? Yes No

How did you hear about QT2?

Date you are available for employment:

Are you willing to travel if the job requires? Yes No Occasionally

 

 

Education/Training

High School Location Course / Degree
College/University Location Course / Degree
Apprentice, Business or Vocational School Location Course / Degree

Grades, Awards, Accomplishments:

Printing Experience:

Do you have experience working in the printing industry? Yes No
(experience is not required for all positions which we employ)    

If YES, please list all printing and bindery equipment which you have operated:

(please also list this information under the appropriate sections of your job history)

Other Training and Skills

Foreign Languages

 

 

Current Employment

Company Name Telephone
Address Hire Date (month and year)

Name of Direct Supervisor:

 Your Job Title and brief description of work

 

Current Salary: $ Hourly Weekly Monthly Annual

Your Status With Current Employer

Actively Working Temporary Layoff Other:
      (provide brief explanation)

 

 

Employment History

Please list employment history starting with most recent.  Include unemployment periods, service with the military, voluntary and/or part-time work.

Company Name Telephone
Address   Employed From Employed To
  Month:  Year: Month:  Year:
Name of Direct Supervisor Your Reason For Leaving

 Your Job Title and brief description of work

 

Ending Salary: $ Hourly Weekly Monthly Annual

 

Company Name Telephone
Address   Employed From Employed To
  Month:  Year: Month:  Year:
Name of Direct Supervisor Your Reason For Leaving

 Your Job Title and brief description of work

 

Ending Salary: $ Hourly Weekly Monthly Annual

 

Company Name Telephone
Address   Employed From Employed To
  Month:  Year: Month:  Year:
Name of Direct Supervisor Your Reason For Leaving

 Your Job Title and brief description of work

 

Ending Salary: $ Hourly Weekly Monthly Annual

 

Company Name Telephone
Address   Employed From Employed To
  Month:  Year: Month:  Year:
Name of Direct Supervisor Your Reason For Leaving

 Your Job Title and brief description of work

 

Ending Salary: $ Hourly Weekly Monthly Annual

 

 

Miscellaneous Information

 

Are you 18 years of age or older?     Yes   No

Upon employment, can you submit verification of your legal right to work in the United States?     Yes   No

Have you been convicted of a felony in the past 10 years?     Yes   No

Date of conviction(s):

Description of conviction(s):

 

Have you ever been involuntarily terminated or have you resigned after being told you would be involuntarily terminated? Yes No

 

If yes, explain:

Are you known to any of the above employers by a different name? Yes No

If yes, please specify name(s), location(s) and date(s).

May QT2 contact your current employer? Yes No

Have you ever been bonded? Yes No

If yes, with what employers?

Are you currently or will you be bound by non-disclosure / non-competition agreements?    Yes    No

 

 

Additional Information

Membership in professional and civic organizations, special accomplishments, awards, hobbies, etc.

(Exclude those which may disclose your race, color, religion, age, or national origin.)

 

Note: Drug Screening, Personal Credit, and Background checks are standard and mandatory for all positions in which we hire.

 

Conditions of Employment

 

In filing this Application form, I understand that QT2 will investigate the facts and statements submitted by me. I hereby grant QT2 permission to check any of this information. This includes reference checks with present employers.


I also understand that any falsifications, omissions, or misrepresentations of facts upon this application will be adequate grounds for my not being hired, or my dismissal, at the discretion of QT2, regardless of when discovered or acted upon by QT2.


This application is not an employment agreement. I understand that should I obtain employment at QT2, I must abide by its rules, regulations and policies, and further agree that my employment and compensation are at the will of QT2 and can be terminated, with or without cause, and with or without notice, at the option of either QT2 or myself. I understand and agree that no one, other than an executive officer of QT2, has the authority to enter into any employment agreement with terms contrary to the foregoing and then only in writing signed by such officer.


By signing this statement, I give QT2 permission to perform a background investigation - including information as to my personal credit standings and criminal record.


By signing this statement, I understand that QT2 may require a medical examination upon acceptance of an employment agreement, to help ensure that I am able to perform job duties safely. I also understand that drug screening is a mandatory requirement upon acceptance of a job offer. I further understand that a result of positive from a requested drug screening is adequate grounds for termination of my employment with QT2.


To assist in the processing of my Application, I waive all rights and claims I may otherwise have against QT2 or its representatives, for seeking, and using information to evaluate my employment request and all other persons, corporations or organizations who provide information for this purpose.

 

 

Date:        Signature of Applicant (digital):

 

 

NOTE: Incomplete applications will be discarded upon receipt.
Applications are kept on file with our Human Resources office for 12 months.
Make application follow-up requests IN WRITING ONLY to: HR Manager, P.O. Box 758, Tiffin, OH 44883.