Chemical Processing: Careers

QUALITY POLICY

We are committed to producing the highest quality products and services, to mutually agreed upon customer standards, expectations and needs. We will meet these goals by implementing all the applicable elements of QS-9000's Quality System Requirements in all areas.

CAREER APPLICATION FORM

Chemical Processing Inc. prides itself on being an equal opportunity employer. Please complete the Career Application Form below in its entirety and submit it.

A representative from Chemical Processing Inc. will contact you for a possible interview.

Last Name

Given Name(s)

E-mail

Address

Street

Apt. No

Home Phone Number

City

State

Zip Code

Business Phone Number

Are you legally eligible to work in the U.S.A.?

Yes

Are you between 18 and 65 Years of Age?

Yes

Position being applied for?

Date available to begin work

Are you available to work:

Full Time

Shiftwork

Casual

Part-time

Temporary

From:

To:

Salary Expectations:

Location Preferred:

Is any member of your family currently employed by Chemical Processing Inc.? If yes, state name, department and relationship.

Yes

In case of emergency state name and telephone number of person(s) to be notified:

Primary Contact
Name	Work Phone Number	Relationship

Secondary Contact
Name	Work Phone Number	Relationship

Are you on lay off and subject to recall?	Yes	No
Are you aware of any reason which would prevent you from being bonded if required?	Yes	No
Where you ever employed by Chemical Processing Inc. or one of its subsidiary companies?	Yes	No

If yes, which company	Location
Dates

Educational Background
High School
Grade Completed	Date
College
Certificate/Diploma Completed	Date
University
Degree Completed	Date
Other
Work Related Skills
Computer	With what microcomputer hardware and software do you have working level skills?
Equipment	With what other special machines or equipment do you have working level skills?
Languages	What languages, other than english, do you speak/read/write fluently?
Other	List any pertinent information not included above which you feel relates to your suitability for employment.

Employment Record

1. Dates: From To:
Company:
Address:
Name of Immediate Supervisor Telephone:
Position held:
For employment purposes, may we contact: Yes No
Final salary:
Reason for leaving:

Duties & Responsibilities

2. Dates: From To:
Company:
Address:
Name of Immediate Supervisor Telephone:
Position held:
For employment purposes, may we contact: Yes No
Final salary:
Reason for leaving:

Duties & Responsibilities

3. Dates: From To:
Company:
Address:
Name of Immediate Supervisor Telephone:
Position held:
For employment purposes, may we contact: Yes No
Final salary:
Reason for leaving:

Duties & Responsibilities

1.	I acknowledge that I have read, fully completed and understand all of this application form. I hereby certify that the foregoing information is true, complete in every respect and I understand and agree that any false or inaccurate statements or omissions will constitute just cause for dismissal from the employ of the Chemical Processing Inc.
2.	I hereby consent to Chemical Processing Inc. making personal inquiries as may be necessary in order to verify the information I have provided and release any and all respondents to such inquiries from all liability which may arise from disclosure of such information.

Date:

Name: