Join our Team v3

AVAILABLE POSITIONS ========================================

Select Position*
—Please choose an option—1st shift Molders – Bristol, CT1st shift Assemblers – Bristol, CT1st shift Inspectors – Bristol, CT1st shift Driver/Receiving – Bristol, CT1st shift Assemblers – Pawcatuck, CT2nd shift Molders – Bristol, CT2nd shift Assemblers – Bristol, CT2nd shift Inspectors – Bristol, CT2nd shift Driver/Receiving – Bristol, CTANY

Date Available for Work
Desired Salary
Referral Source

YOUR INFO ========================================

First Name*
Middle Name*
Last Name*

Address*
Phone*
Email*

EMPLOYMENT INFO ========================================

Have you filed an application here before?*
YesNo

If yes, When?

Have you interviewed with us in the past?*
YesNo

If yes, When?

Have you ever been employed here before?*
YesNo

If yes, When?

Are you currently employed?*
YesNo

If yes can we contact your current employer?*
YesNo

If you are under 18, can you furnish a work permit?*
YesNo

Are you currently authorized to work in the United States?*
YesNo

EDUCATION HISTORY ========================================

High School Course-Major Degree Received

College Course-Major Degree Received

Other/Trade Course-Major Degree Received

Summarize any special skills or qualifications acquired from employment or other experiences that may qualify you to work in the position you have applied for:

WORK HISTORY ========================================

Name & Address of Employer (1) Position Dates Reason for Leaving
Name & Address of Employer (2) Position Dates Reason for Leaving
Name & Address of Employer (3) Position Dates Reason for Leaving

REFERENCES ========================================
*List name and telephone number of business/work references who are not related to you

Name (1) Position Company Phone Years Known
Name (2) Position Company Phone Years Known
Name (3) Position Company Phone Years Known

EMERGENCY CONTACT ========================================

Emergency Contact*
Emergency Phone*
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