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DLG Coatings, Inc.
Application for Employment
Equal Opportunity Employer
Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap or veteran status.
 
PERSONAL INFORMATION

















EDUCATION INFORMATION
COLLEGE


BUSINESS / TRADE / TECHNICAL


HIGH SCHOOL


US MILITARY SERVICE


JUDICIAL RECORD


PERSONAL REFERENCES
List any relatives or friends working for this organization:
List one personal reference who we may contact at this time
WORK EXPERIENCE
Please provide us with a chronological history of your employment, beginning with your most recent employer. Account for all time during the last ten years, including U.S. military service, self-employment and unemployment. Should your work history extend beyond ten years, please attach additional sheets following the same format.










EMERGENCY CONTACT
We recognize you have the right to terminate your employment at will whenever you choose, for any reason. The Company reserves to itself the same right. Employment at will status cannot be modified excepti upon the express written authorization of the President of the Company. I certify that the answers given by me in this application are true and correct. I agree that the Company shall not be liable in any respect if it terminates my employment because of omissions or false statements made by me in this application. Should I be offered employment with the Company, I agree to submit to a medical examination and/or urinalysis test and authorize the release of the results to the Company. All offers of employment are conditional upon receiving a favorable result on the medical examination and urinalysis test. I understand that the Company has a substance abuse prevention policy. I agree that during my employment with the Company, I may be required to, and hereby consent to, furnish my urine or blood for substance abuse testing pursuant to such policy.
Incomplete applications will not be considered.
 
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