Service Engineering Inc. Application for Employment Form

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	1-877-727-8333
Manufacturing fine vibratory feeders, centrifugal feeders, vision systems, feeder bowls, and many other types of parts handling systems since 1967.

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Application Form

At the Factory Sales Reps Wanted Application Form

Name:
Address:
City/State/Zip
Phone Number:
E-mail:
What position are you applying for?
Wage or salary desired:
Are there any hours, shifts, or days you cannot or will not work?
Are you over 18 years old?	Yes No
Do you have the legal right to be employed in the United States?	Yes No
Have you worked here before?	Yes No
Are you willing to work overtime as required?	Yes No
Are you currently employed?	Yes No

Education
Education:
If "Other" please specify:
Year you graduated:

Work History #1 List your last (2) employers, beginning with the most recent one first.
Name of employer:
Address/Telephone
Date started:
Starting position:
Date left:
Position on leaving:
Reason for leaving:
Description of duties

Work History #2
Name of employer:
Address/Telephone
Date started:
Starting position:
Date left:
Position on leaving:
Reason for leaving:
Description of duties

Other notes In addition to your work history, what other experiences,skills, or qualifications would especially fit you for work with our company?

By submitting this inquiry, I authorize the Company to make an investigation of any of the facts set forth in this inquiry. I understand that my potential employment would be "at-will" and could be terminated at any time by either party, with or without cause and with or without possible notice.

2190 West Main Street
Greenfield, Indiana 46140

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