About

It is not necessary to disclose any information regarding race, creed, color or national origin. The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.

Name

Date

Month

Day

Year

Birthdate

Month

Day

Year

Email Address

Social Security No.

Have you ever been employed under a different name?

Yes

If yes, what

Street Address

City

State

Zip Code

Telephone Number(s)

How long have you lived at above address

Years Years

Months Months

How long have you lived in this metro area?

Years Years

Months Months

Are you at least eighteen years old?

Yes

Are you eligible to work in the USA?

Yes

Are you available for:

Full-time

Part-time

Temporary

If temporary, indicate dates available

Position Desired

Welder

Pipefitter

Earning Expected $

Earning Type

Hourly

Monthly

Other Position(s)

Date available to start work

Month

Day

Year

Have you previously been employed at this company or any subsidiary of SPSI?

Yes

If yes, date employed

From

Month

Day

Year

Month

Day

Year

Do you have any relatives or friends employed here or at any other subsidiary of SPSI?

Yes

If yes, fill in below

Name

Relationship

Name

Relationship

Have you ever been convicted of a felony or pleaded guilty to a felony?

Yes

If yes, fill in date(s) of any felony, the location(s), the type(s) of felony, the date(s) of any conviction and any prison time.

Note: A conviction record will not necessarily be a bar to employment and factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account.

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