Mechanic Application

Mechanic

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Mechanic Position Application

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GENERAL INFORMATION

Name:

Date of Birth:

Driver's License Number AND Issuing State:

Phone:

Address:

Email Address:

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Are you able to perform the essential job functions of the position for which you are applying with or without a reasonable accomodation?

Yes

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Have you been convicted of any felonies other than minor traffic violations during the past seven years? ( A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonable relates to your fitness to perform in the position you are applying for.)

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EDUCATION

Grade Last Completed

College

High School

College

Trade, Business, or Correspondence

List any scholorships

List any Mechanical/Maintenance skills you have that may help in this position:

List special courses or training that will help you for the mechanic/maintenance position:

List special equipment or technical materials you can work with

List any tools you currently have/use:

List types of equipment maintained:

Describe your welding experience:

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If required, will you work:

Overtime?

Saturdays?

Alternation shifts?

On Call?

Salary Requirements:

Date you can start:

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EMPLOYEMENT HISTORY

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Starting with your PRESENT or MOST RECENT EMPLOYER, list in consecutive order ALL EMPLOYMENT for atleast the past FOUR employers

If currently employed, may we contact your employer?

Full Name of Company:

Telephone:

Street Address:

City:

State:

Zip:

Name & Title of Supervisor:

Title of Your Position:

List jobs held, duties performed, skills used & promotions while employed at this company:

Salary (Begin)

Salary (End)

Employed From:

Employed To:

Reason For Leaving:

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Full Name of Company:

Telephone:

Street Address:

City:

State:

Zip:

Name & Title of Supervisor:

Title of Your Position

List jobs held, duties performed, skills used, & promotions while employed at this company:

Salary (Begin)

Salary (End)

Employed From:

Employed To:

Reason for leaving:

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Full Name of Company:

Telephone:

Street Address:

City:

State:

Zip:

Name & Title of Supervisor:

Title of Your Position:

List jobs held, duties performed, skills used, & promotions while employed at this company:

Salary (Begin)

Salary (End)

Employed From:

Employed To:

Reason For Leaving:

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Full Name of Company:

Telephone:

Street Address:

City:

State:

Zip:

Name & Title of Supervisor:

Title of Your Position:

Lists jobs held, duties performed, skills used, & promotions while at this company:

Salary (Begin)

Salary (End)

Employed From:

Employed To:

Reason For Leaving:

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ACCIDENT RECORD FOR THE PAST 3+ YEARS

Date:

Nature of Accident:

Fatalities:

Injuries:

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Date:

Nature of Accident:

Fatalities:

Injuries:

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Date:

Nature of Accident:

Fatalities:

Injuries:

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Traffic Convictions & Forfeitures for the past 3 years (other than parking violations)

Location:

Date:

Charge:

Penalty:

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Location:

Date:

Charge:

Penalty:

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Location:

Date:

Charge:

Penalty:

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Location:

Date:

Charge:

Penalty:

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A. Do you have a Commercial Drivers License (CDL)?

If so, what class?

B. Have you ever been denied a license, permit or privilege to operate a motor vehicle?

C. Has any license, permit or privilege ever been suspended or revoked?

If the answer to either B or C is yes, give details:

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Type of Equipment

Dates

Approx. Number of Miles:

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Type of Equipment:

Dates

Approx. Number of Miles

Online Bill Payment

Call Us Today

Hilltopper Main Office

W6833 Industrial Blvd, Onalaska, WI 54650

M-F: 8am - 5pm

Sat: 8am - 12noon

Onalaska Recycling Center

W6836 Industrial Blvd, Onalaska, WI 54650

M-F: 8:30am - 4:30pm

Sat: 8:30am -11:30am

Arcadia Recycling Center

1420 Wanek Ave, Arcadia, WI 54612

Tues, Wed & Fri: 1:00pm - 4:30pm

Thurs: 1pm - 6:30pm

Sat: 8am - 12noon

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Slide title

Mechanic Position Application