Shinn Brothers, Inc.
4457700342900Shinn Brothers, Inc.“Equal Opportunity Employer”540 W. Summit St. ~ Celina, OH 45822Phone: 419-586-5000 Fax: 419-586-661500Shinn Brothers, Inc.“Equal Opportunity Employer”540 W. Summit St. ~ Celina, OH 45822Phone: 419-586-5000 Fax: 419-586-661551117545720000Employment ApplicationApplicant InformationFull Name: FORMTEXT ????? FORMTEXT ????? FORMTEXT ???Date: FORMTEXT ?????LastFirstM.I.Address: FORMTEXT ????? FORMTEXT ?????Street AddressApartment/Unit # FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????CityStateZIP CodePhone:( FORMTEXT ?????) FORMTEXT ?????E-mail Address: FORMTEXT ?????Date Available: FORMTEXT ?????Social Security No.: FORMTEXT ?????Desired Salary:$ FORMTEXT ?????Position Applied for: FORMTEXT ?????Are you a citizen of the United States?YES FORMCHECKBOX NO FORMCHECKBOX If no, are you authorized to work in the U.S.?YES FORMCHECKBOX NO FORMCHECKBOX Have you ever worked for this company?YES FORMCHECKBOX NO FORMCHECKBOX If yes, when? FORMTEXT ?????Have you ever been convicted of a felony?YES FORMCHECKBOX NO FORMCHECKBOX If yes, explain: FORMTEXT ????? YES NODo you have a CDL? FORMCHECKBOX FORMCHECKBOX Do you have heavy equipment experience? If yes, describe: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________EducationHigh School: FORMTEXT ?????Address: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Did you graduate?YES FORMCHECKBOX NO FORMCHECKBOX Degree: FORMTEXT ?????College: FORMTEXT ?????Address: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Did you graduate?YES FORMCHECKBOX NO FORMCHECKBOX Degree: FORMTEXT ?????Other: FORMTEXT ?????Address: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Did you graduate?YES FORMCHECKBOX NO FORMCHECKBOX Degree: FORMTEXT ?????ReferencesReferences.Full Name: FORMTEXT ?????Relationship: FORMTEXT ?????Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Full Name: FORMTEXT ?????Relationship: FORMTEXT ?????Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Full Name: FORMTEXT ?????Relationship: FORMTEXT ?????Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Previous EmploymentCompany: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Supervisor: FORMTEXT ?????Job Title: FORMTEXT ?????Starting Salary:$ FORMTEXT ?????Ending Salary:$ FORMTEXT ?????Responsibilities: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Reason for Leaving: FORMTEXT ?????May we contact your previous supervisor for a reference?YES FORMCHECKBOX NO FORMCHECKBOX Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Supervisor: FORMTEXT ?????Job Title: FORMTEXT ?????Starting Salary:$ FORMTEXT ?????Ending Salary:$ FORMTEXT ?????Responsibilities: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Reason for Leaving: FORMTEXT ?????May we contact your previous supervisor for a reference?YES FORMCHECKBOX NO FORMCHECKBOX Company: FORMTEXT ?????Phone:( FORMTEXT ?????) FORMTEXT ?????Address: FORMTEXT ?????Supervisor: FORMTEXT ?????Job Title: FORMTEXT ?????Starting Salary:$ FORMTEXT ?????Ending Salary:$ FORMTEXT ?????Responsibilities: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Reason for Leaving: FORMTEXT ?????May we contact your previous supervisor for a reference?YES FORMCHECKBOX NO FORMCHECKBOX Military ServiceBranch: FORMTEXT ?????From: FORMTEXT ?????To: FORMTEXT ?????Rank at Discharge: FORMTEXT ?????Type of Discharge: FORMTEXT ?????If other than honorable, explain: FORMTEXT ?????Disclaimer and SignatureI certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.Signature:Date: ................
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