Privacy Agreement

Reich Tool & Design is an Equal Employment Opportunity Employer and gives all applicants for employment equal consideration regardless of race, color, sex, religion, national origin, ancestry, age, physical or mental disability, sexual orientation, genetic information, marital status, citizenship status, veteran status, pregnancy, height, weight, or other protected class by federal, state or local law. Upon request and consistent with applicable laws, Reich Tool will provide reasonable accommodations to individuals with disabilities who need an accommodation to fully participate in the application process. Please contact the number referenced below. Before completing application please read the following. I certify that all the answers will be true, accurate and complete. I understand that the omission and/or misrepresentation of any fact from or on this application and/or during any interview will result in immediate rejection of my application or if I am hired cause for immediate termination. Unless I noted otherwise, I authorize the company to contact employment and personal references. If hired I agree to abide by all the rules and regulations of the company. I understand and agree that nothing in this application shall constitute an offer, a contract or a guarantee of employment for a specific period of time. If hired, I understand my employment is at will and may be terminated with or without cause and with or without notice at any time, at the option of Reich Tool & Design or myself. I further understand that no representative or agent of the Company, other than the President of the company, has the authority to enter into any agreement for employment for any specific period of time, or to make an agreement contrary to the forgoing. I also understand that any agreement modifying my at will employment status must be in writing and signed by the President. Applicants for employment who have a disability may contact (262) 252-3440 to request assistance and/or a reasonable accommodation. I Agree

Personal Information

First Name

Middle Name

Last Name

Address

Telephone #

Cellular/Other Phone #

Email Address

Position Applied For

Referral Source Walk-In Employee Advertisement Company's Website Other Internet School Job Fair Staffing Agency Government Employee Agency Other

If Employee, Job Fair or Other please specify

If you are under 18 and it is required, can you furnish a work permit? Yes No

Have you submitted an application here before? Yes No

Have you ever been employed here before? Yes No

If yes, give dates:

Are you eligible for employment in this country? Yes No

Employment History

Starting with your most recent employer, provide the following information.

Employer 1

Telephone #

Dates employed: (To / From)

Employer Address

Starting job title/Final job title

Immediate supervisor and title (for most recent job held)

Employer 2

Telephone #

Dates employed: (To / From)

Employer Address

Starting job title/Final job title

Immediate supervisor and title (for most recent job held)

Employer 3

Telephone #

Dates employed: (To / From)

Employer Address

Starting job title/Final job title

Immediate supervisor and title (for most recent job held)

Employer 4

Telephone #

Dates employed: (To / From)

Employer Address

Starting job title/Final job title

Immediate supervisor and title (for most recent job held)

Employer 5

Telephone #

Dates employed: (To / From)

Employer Address

Starting job title/Final job title

Immediate supervisor and title (for most recent job held)

Educational Background

School (City, State and years completed)

School (City, State and years completed)

Applicant Statement

Please upload your resume

Electronic Signature of Applicant

Date

Please enter the following data