Application for Employment
 
 
Date of Application:    
Position(s) applied for:    
     
       
First Name:  A value is required.
Middle Name:  A value is required.
Last Name:  A value is required.
Address:  A value is required.
City:  A value is required.    
  State:   Zip Code: 
Phone:  A value is required.    
  Email:     
       
 

If you are under 18 years of age, can you provide required proof of your eligibility to work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes   No
Have you ever filed an application with us before? . . . . . . . . . . . . . .

Yes   No
    If yes, give date: 

Have you ever been employed with us before? . . . . . . . . . . . . . . . . .
Yes   No
    If yes, give date: 

Do any of your friends or relatives, other than spouse, work here? . .

Yes   No
Are you currently employed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Yes   No
May we contact your present employer? . . . . . . . . . . . . . . . . . . . . .


Yes   No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? . . . . . . . . . . . . . . . . . . . . . .
(Proof of citizenship or immigration status will be required upon employment)

Yes   No
Date available to work: . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

What is your desired salary range? . . . . . . . . . . . . . . . . . . . . .

What are you available to work? . . . . . . . . . . . . . . . . . . . . . .

Part-Time   Full-Time
Are you currently on "lay-off" status and subject to recall? . . . .

Yes   No
Can you travel if a job requires it? . . . . . . . . . . . . . . . . . . . . .

Yes   No
Do you have a valid Driver License? . . . . . . . . . . . . . . . . . . . .

Yes   No
Have you been convicted of a felony within the last five years?
(A criminal record does not constitute an automatic bar to employment and will be considered only as it relates to the job in question.)

Yes   No
WE ARE AN EQUAL OPPORTUNITY EMPLOYER

 
Education

Education
Did You Graduate
Degree / Subject Studied
________________________________________________________________________________________________
     
High School

Yes  No

________________________________________________________________________________________________
     

College

Yes No

________________________________________________________________________________________________
     
Trade, Business or Corresponding School Yes No
 
Employment History

Employer #1

Employer:  Date Employed
Address:  From: 
Telephone #:  To: 
Job Title:  Hourly Rate / Salary
Supervisor:  Starting: 
Reason for leaving:  Final: 
Work Performed: 
May we contact this employer?
Yes  No
_____________________________________________________________________________

Employer #2

Employer:  Date Employed
Address:  From: 
Telephone #:  To: 
Job Title:  Hourly Rate / Salary
Supervisor:  Starting: 
Reason for leaving:  Final: 
Work Performed: 
May we contact this employer?
Yes  No
_____________________________________________________________________________

Employer #3

Employer:  Date Employed
Address:  From: 
Telephone #:  To: 
Job Title:  Hourly Rate / Salary
Supervisor:  Starting: 
Reason for leaving:  Final: 
Work Performed: 
May we contact this employer?
Yes  No
_____________________________________________________________________________

Employer #4

Employer:  Date Employed
Address:  From: 
Telephone #:  To: 
Job Title:  Hourly Rate / Salary
Supervisor:  Starting: 
Reason for leaving:  Final: 
Work Performed: 
May we contact this employer?
Yes  No

 
References
Reference #1
Full Name:  Phone: 
Address:     
_____________________________________________________________________________
Reference #2
Full Name:  Phone: 
Address:     
_____________________________________________________________________________
Reference #3
Full Name:  Phone: 
Address:     
 
Please mail or email a cover letter and resume with your application.

Mailing Address:

Employment Opportunities
Penna Flame Industries
1856 State Route 588
Zelienople, PA 16063

Email Address: employment@pennaflame.com
 
Applicant's Statement

I certify that answers given herein are true and complete.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this 'at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.
In the event of employment, I understand that false or misleading informationgiven in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
       
  I have read and understand the above statement.    
         
   
   
       
         
Penna Flame Industries
1856 State Route 588, Zelienople, PA 16063
P: 724.452.8750 • F: 724.452.0484