Complete and submit the following to apply.

First name

Last name

Phone

Address

City

State

Zip Code

Position Applying For

Type of Employment Sought

Regular Full Time

Part Time

Temporary

As Needed

Salary Expected

Date Available for Work

Referred By

Have you previously been employed by LMC?

Yes

Do you have relatives employed by LMC?

Yes

Have you ever been convicted of a felony?

Yes

*Compliance with Immigration and Naturalization Service I-9 requirements is mandatory upon employment.

Are you a U.S. citizen?

Yes

Answer the following for all positions requiring the use of a vehicle:

Do you have a DOT Commercial Driving License?

Yes

Have you ever been convicted of a moving traffic violation?

Yes

Military Service

Have you ever served in the military?

Yes

Education

HIGH SCHOOL

Name of High School

Address

Highest Grade Level Completed

Did you receive a High School Diploma or GED?

Yes

VOCATIONAL/TECHNICAL SCHOOL

Name of Vocational/Technical School

Address

Did you graduate?

Yes

Number of Years Completed

Number of Credit Hours Completed

COLLEGE/UNIVERSITY

Name of College/University

Address

Did you graduate?

Yes

Number of Years Completed

Number of Credit Hours Completed

List skills, special training, and qualifications you possess pertaining specifically to the position being applied for. Include equipment with which you have experience and training, job related training, computer skills, certifications, or licenses.

WORK EXPERIENCE

List your current or most recent employer first.

Company

Phone

Address

Supervisor Name and Title

Position Held

Start Date

Starting Salary

End Date

Ending Salary

May we contact this employer?

Yes

Describe Job Duties and Responsibilities:

Reason for Leaving Job:

Second-Most Recent Employer

Company

Phone

Address

Supervisor Name and Title

Position Held

Date

Starting Salary

Date

Ending Salary

May we contact this employer?

Yes

Describe Job Duties and Responsibilities:

Reason for Leaving Job

CONDITIONS OF EMPLOYMENT

To Applicant: Read the following information carefully and submit below.

*For the purposes of validity, enforceability and admissibility, the applicant's typed name and submission is conclusive evidence of the applicant's intention to be legally bound as if such signature had been written by hand.

The facts as stated on this application are true and correct. I understand that, if employed, false statements on this application may be cause for my immediate dismissal.
I authorize such background and personal reports as deemed necessary to verify the information I have provided is true and accurate and to determine my fitness for this job. A copy of this authorization is as valid as the original.
I understand that I may be required to work overtime as a condition of employment.
In consideration of my employment, I agree to conform to the rules and regulations for employees of Lexington Manufacturing Center. I understand that my employment and compensation can be terminated, with or without cause, at any time, at the option of either Lexington Manufacturing Center or myself. I understand that no representative of Lexington Manufacturing Center has any authority to enter into any verbal agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.
I understand that I may be required to submit to a pre-employment and past employment test for fitness, honesty, and/or substance abuse, unless prohibited by law.
Upon separation of employment, I authorize Lexington Manufacturing Center to withhold from my final pay check any money owed to Lexington Manufacturing Center by me.

Applicant Name