Employment Application Last Name(Required) Middle Name(Required) First Name(Required) Present Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Permanent Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Are you 16 years old or older?(Required) Yes No Are you 18 years old or older?(Required) Yes No Phone Number(Required)Work Phone NumberEmail Address Enter Email Confirm Email Best Time to Contact You at Home Emergency Contact Emergency Contact Address Emergency Contact Phone NumberAre you lawfully authorized to work in the United States(Required) Yes No (Proof of right to work in the United States will be required upon employment.)Position (Choose up to three)(Required) Accountant Accounting Clerk Administrative Assistant Apprenticeship Program – SWIC Drafter/Designer Contract Administrator Electrician Electrical Designer Engineer-Design Engineer-Electrical Engineer-Industrial Engineer-Product Safety Full Stack Software Developer IT Help Desk Support Technician Janitor Legal Assistant Machinery Builder Machinist Maintenance Material Handler Mechanic Network Administrator Painter Paralegal Part Time Plant Payroll Specialist PLC Programmer Production Assistant, Entry Level Production Worker Purchasing Agent Safety Coordinator Sales Engineer Sales Professional, Technical Saw and Drill Secretary Service Technician, Industrial Software Developer/Engineer Stockroom Clerk Technical Writer Tier 1 IT Help Desk Technician Welder Available Start Date(Required) MM slash DD slash YYYY Salary Desired(Required) Please list the position selected above along with the desired salary for each position selected.PerWeekMonthYearAre you employed now? Yes No If so, may we contact your present employer? Yes No Have you ever applied to this company before? Yes No When Have you ever worked for this company before? Yes No When Reason For Leaving Name of Last Supervisor at this Company Do any of your friends or relatives, other than spouse, work here? Yes No If yes, state Name & Relationship Who referred you to Red Bud Industries, Inc.?(Required)Please choose from dropdownCurrent Employee – Please provide name of Employee in field below.Illinois Department of Employment Security (IDES)Internet SearchJob Fair – Please provide location of Job Fair in “Additional Information” field below.Job Board – Please provide name of Job Board in "Additional Information" field below.Newspaper – Please provide name of Newspaper in "Additional Information" field below.Red Bud Chamber of CommerceRed Bud Industries’ SignRed Bud Industries’ WebsiteSchool – Please provide name of School in “Additional Information” field below.Zip RecruiterOther – Please provide brief explanation if not listed above in Additional Information” field below.Name of Employee who referred you(Required) Are you available to work:What shifts are you available to work? Full Time 1 Shift 2 Shift 3 Shift Part Time Mornings Afternoons Evenings Internship Co-op Summer Temporary Please indicate dates available Are you currently on "lay-off" status & subject to recall? Yes No Can you travel if a job requires it? Yes No Education Grade SchoolName & Location of School Did you graduate? Yes No High SchoolName & Location of School Did you graduate? Yes No Courses of Study Undergraduate / Graduate / Other (Specify)Name & Location of School Did you graduate? Yes No Courses of Study Additional InformationDescribe Any Specialized Training, Apprenticeship, And Skills:Describe Any Job-related Training Received In The United States Military:List Job-related Professional, Trade, Business, Extracurricular, Or Civic Activities:Other QualificationsSummarize Specialized Skills, Equipment Operated, & Other Job-related Skills & Qualifications Acquired From Employment Or Other Experience. State Any Additional Information You Feel May Be Helpful To Us In Considering Your Application.Work Experience Start with your present or last job. Include any job-related military service assignments and volunteer activities. Present EmployerName & Address of EmployerStarting Date (month/year) Job Title Name & Title of Supervisor Phone NumberDescription of Work:Previous Employer 1Name & Address of EmployerStarting Date (month/year) Leaving Date (month/year) Job Title May we contact your supervisor? Yes No Name & Title of Supervisor Phone NumberDescription of Work:Reason for leaving Previous Employer 2Name & Address of EmployerStarting Date (month/year) Leaving Date (month/year) Job Title May we contact your supervisor? Yes No Name & Title of Supervisor Phone NumberDescription of Work:Reason for leaving Previous Employer 3Name & Address of EmployerStarting Date (month/year) Leaving Date (month/year) Job Title May we contact your supervisor? Yes No Name & Title of Supervisor Phone NumberDescription of Work:Reason for leaving Previous Employer 4Name & Address of EmployerStarting Date (month/year) Leaving Date (month/year) Job Title May we contact your supervisor? Yes No Name & Title of Supervisor Phone NumberDescription of Work:Reason for leaving Previous Employer 5Name & Address of EmployerStarting Date (month/year) Leaving Date (month/year) Job Title May we contact your supervisor? Yes No Name & Title of Supervisor Phone NumberDescription of Work:Reason for leaving Previous Employer 6Name & Address of EmployerStarting Date (month/year) Leaving Date (month/year) Job Title May we contact your supervisor? Yes No Name & Title of Supervisor Phone NumberDescription of Work:Reason for leaving References Give the names of three persons not related to you, whom you have known at least one year that we may contact. Reference 1Name Address Business Phone NumberEmail Address Best Time to Call Years Acquainted Reference 2Name Address Business Phone NumberEmail Address Best Time to Call Years Acquainted Reference 3Name Address Business Phone NumberEmail Address Best Time to Call Years Acquainted Equal Opportunity Employer This company is an Equal Opportunity Employer. We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, citizenship status, ancestry, sex, sexual orientation, gender, gender identity or gender transitioning, genetic predisposition or genetic information, age, disability, pregnancy, marital status, military discharge or veteran status, arrest records, criminal convictions which have been sealed or expunged, or any other legally protected status. In connection with your application for employment, you may be required to take a written pre-employment test. We will provide reasonable accommodations in the testing process for disabled individuals. If you require any accommodations in the testing process, please notify your personnel interviewer. Applicant Statement Applicant Statement It is understood and agreed the information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, test scores, or any other materials, or during any interview, can be justification for refusal of employment, or, if employed, termination from the company’s employment, regardless of when or how it was discovered. For employment purposes as may be necessary in arriving at an employment decision, I give the company the right to investigate all statements contained herein and the references, including past employers listed, and to secure additional information about me, whether personal or otherwise. I hereby release the company and its representatives, as all those who furnish such information, from all liability for any damage that may result from seeking or utilization of such information as well. In connection with this application, certain positions require an investigative report which may include a credit report, criminal record report, and/or a motor vehicle report. If any such report is needed, I will be notified in advance to obtain my written consent. I understand that a poor credit history and/or a conviction will not automatically result in disqualification from employment. I understand that I am subject to a urinalysis for drug testing purposes and physical examination. The results of such examinations will be made available to the Company. My failure or refusal to provide necessary consents may terminate my application, candidacy, or employment. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant Federal and State laws. I understand that the company is an Equal Opportunity Employer and does not discriminate in employment and no question on this application is to be used for the purpose of limiting or excluding any applicant’s consideration for employment on a basis prohibited by Local, State, or Federal law. I understand that this application for employment is not an offer or contract for employment. 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 the President of the Company. If offered employment, I agree to comply with the policies, rules, regulations, and procedures of the company which may be changed from time to time at the sole discretion of the Company. I further understand that the company reserves the right to change wages, hours and working conditions as deemed necessary. 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 and signed by the President of the Company. I understand that any employment offer is contingent upon my providing, within three working days of employment, valid proof of identity and eligibility to work in order to comply with the Immigration Reform and Control Act of 1986. Mechanical Test We may ask that you take a mechanical test because our business requires high mechanical ability. This is not an intelligence test. Low test scores do not reflect on one’s personal character or overall talent. We will provide reasonable accommodations in the testing process for disabled individuals. Thank you for applying at our company. By checking this box, I have read and fully understand and agree with the above information. I hereby affirm and acknowledge by checking this box that I am providing my electronic signature, which carries the same legal weight associated with an original signature on a paper document.Consent(Required) I Understand(Required)Applicants Initials(Required) Initial Date(Required) MM slash DD slash YYYY Background Information Your work history will be discussed with you if you are interviewed. Please answer all the following questions with yes or no. Have you ever been:Placed on probation or terminated for poor job performance?(Required) Yes No Disciplined or fired for insubordination?(Required) Yes No Disciplined or discharged for violating a safety rule?(Required) Yes No Disciplined or terminated for absenteeism, tardiness, failure to notify your company when absent, or any other attendance-related reason not relating to medical issues?(Required) Yes No Disciplined or fired for fighting, assault, or similar offenses?(Required) Yes No Disciplined or discharged for being under the influence of alcohol or drugs, or for possession, use or abuse of alcohol or drugs during the course of employment?(Required) Yes No Have you ever been employed by The Material Works?(Required) Yes No Are you a relative of anyone who currently works for or was employed in the past by The Material Works?(Required) Yes No If so, please list name.I UNDERSTAND THAT IF I AM SELECTED FOR AN INTERVIEW OR UPON A CONDITIONAL JOB OFFER BEING EXTENDED TO ME, THAT THE COMPANY MAY REQUIRE THAT I COMPLETE A CONVICTION INQUIRY QUESTIONNAIRE. By checking this box, I certify that the above answers are true and correct to the best of my information and knowledge. I understand that any falsification or any omission of material information discovered before or after I am employed may be cause for my being disqualified or immediately terminated from employment with the company.Consent(Required) I Understand(Required)Applicants Initials(Required) Initial Date(Required) MM slash DD slash YYYY By submitting this information, I acknowledge and affirm that I have read and fully understand & agree with the information included in this submission. *** THE COMPANY IS AN AT-WILL, EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER *** View Red Bud Industries, Inc.’s Privacy Policy.Consent(Required) I hereby consent to Red Bud Industries, Inc.’s Privacy Policy.(Required)