CASECO Manufacturing's Custom Bodies Gallery




Application for Employment
Please fill out all blanks and click the submit button once at the end of the page.

	Date Month Day Year Personal Information First Name Last Name Present Address Address City State Zip Permanent Address Address City State Zip Phone Referred By Employment Desired Position Date You Can Start Month Day Year Salary Desired Are you employed? Yes No If so, may we contact your present employer? Yes No Ever applied to this company before? Yes No Where? When? Month Day Year Education History Grammar School Years Attended Graduate Yes No Subjects Studied High School Years Attended Graduate Yes No Subjects Studied College Years Attended Graduate Yes No Subjects Studied Trade or Correspondence School Years Attended Graduate Yes No Subjects Studied General Information Subjects of Special Study/Research Work or Special Skills U.S. Military or Naval Service Rank Former Employers (list below last four employers, starting with last one first) From Month Year To Month Year Name & Address Salary Position Reason for Leaving From Month Year To Month Year Name & Address Salary Position Reason for Leaving From Month Year To Month Year Name & Address Salary Position Reason for Leaving From Month Year To Month Year Name & Address Salary Position Reason for Leaving References (give below the names of three person not related to you, whom you have known at least one year. Name Address Business Years Known Name Address Business Years Known Name Address Business Years Known Authorization "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. The waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilites Act (ADA) and other relevant federal and state laws." Date Month Day Year Accept Decline

Route 66 Claremore, OK p: 918-283-2999 f: 918-283-1119 e: admin@casecomfg.com