Apply for a Position

Required fields are printed in bold.

NI Industries

Job Application

Equal access to programs, services and employment is available to all persons. Those applicants requiring a reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department. We are an equal opportunity employer.
Position Applied For*

If you are submitting an application for future openings, leave this field blank.
Application Date

Date you're submitting an application
Personal Information
First Name, Middle Initial*

First
Last Name*

Last Name
Address*

Street
City*
State, Zip Code*
Home Phone*
Cell Number / Other

Another number where we can reach you
E-mail address
Position
Shift Preferred*

1st 2nd 3rd Any
Expected Pay
Would you accept full-time worK?*

Yes No
Would you accept part-time work?*

Yes No
On what date would you be available for work?*
If necessary the best time of day to call you is
How were you referred to NI Industries?
Have you ever applied for a job with NI Industries in the past?*

Yes No
If yes, please give date(s) and position(s)
Have you ever been employed by NI Industries*

Yes No
If yes, please provide dates you were employed
Is this application a request for employment following an extended military leave of absence from NI Industries?

Yes No
If yes, additional infomation may be requested.
If you are under 18 years old, can you provide a work permit if required?*

Yes No Not Applicable
Are you legally eligible for employment in the United States?*

Yes No
If yes, proof is required if hired
Are you able to perform the "essential functions" of the job for which you are applying (with or without reasonable accommodation)?*

Yes No Need more information about the job's "essential functions" to respond
Note: This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage, to the extent permitted by law.
Will you travel if required?*

Yes No
Will you work overtime if required?*

Yes No
If they have been explained to you, are you able to meet the attendance requirements of the position?*

Yes No Not applicable
Have you ever been bonded?*

Yes No
Please provide your driver's license number, if driving is required for the job.
Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way, restrict your ability to work for our Company? *

Yes No
If yes, please eplain
Have you ever pleaded "guilty" or "no contest" to, or been convicted of, a felony?*

Yes No
Noto: Answering "yes" to the following question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account. You are not obligated to disclose sealed or expunged records of conviction or arrest or expunged juvenile records of conviction or arrest.
If yes, please provide date(s) and details
Employment Experience

List your most recent employer first.
Employer 1*

List your most recent employer first
Employer 1 Contact

Who may we contact at this employer to verify employment?
Employer 1 E-mail

E-mail address of contact from this employer
Employer 1 Address
Employer 1 Phone Number
Job Title (Employer 1)

What was your job title while employed with this company?
Supervisor (Employer 1)

Who was your supervisor while working for this employer?
Employment Start (Employer 1), Employment End (Employer 1)

When did you begin working for this employer?
Work Performed (Employer 1)

Please provide a short description of the work you did while working for this employer
Reason for Leaving (Employer 1)

Please briefly describe why you are no longer working for this employer.
Best parts about this position (Employer 1)

What were the things you liked most about your position with this employer?
Least liked parts about this position (Employer 1)

What were the things you liked least about the position?
Employer 2
Employer 2 Contact

Who may we contact at this employer to verify employment?
Employer 2 E-mail

E-mail address of contact from this employer
Employer 2 Address
Employer 2 Phone Number
Job Title (Employer 2), Supervisor (Employer 2)

What was your job title while employed with this company?
Employment Start (Employer 2), Employment End (Employer 2)

When did you begin working for this employer?
Work Performed (Employer 2), Reason for Leaving (Employer 2)

Please provide a short description of the work you did while working for this employer
Best parts about this position (Employer 2)

What were the things you liked most about your position with this company?
Least liked parts about this position (Employer 2)

What were the things you liked least about the position?
Employer 3
Employer 3 Contact

Who may we contact at this employer to verify employment?
Employer 3 E-mail

E-mail address of contact from this employer
Employer 3 Address
Employer 3 Phone Number
Job Title (Employer 3), Supervisor (Employer 3)

What was your job title while employed with this company?
Employment Start (Employer 3)

When did you begin working for this employer?
Employment End (Employer 3)

When did you stop working for this employer?
Work Performed (Employer 3), Reason for Leaving (Employer 3)

Please provide a short description of the work you did while working for this employer.
Best parts about this position (Employer 3)

Whad were the things you liked most about your position with this employer?
Least liked parts about this position (Employer 3)

(Employer 3)
Explain any gaps in your employment, other than those due to personal illness, injury or disability.
Have you ever been fired or asked to resign from a job?*

Yes No
If you have been fired or asked to resign, please explain.
Education Background
High School, High School Location*

Please provide a short description of the work you did while working for this employer.
High School Course of Study
Did you graduate high school?*

Yes No
High School Degree or Diploma
College
College Location

In which city, state, and/or country was your college?
College Course of Study
Did you graduate from this college?

Yes No
College Degree or Diploma
Graduate School, Graduate School Location

Please provide a short description of the work you did while working for this employer.
Graduate School Course of Study
Did you graduate from this graduate school?

Yes No
Graduate School Degree or Diploma
Vocational Training / Other
Location of Vocational Training / Other

In which city, state, and/or country was the vocational training / other?
Vocational Training / Other Course of Study
Vocational Training / Other Degree or Diploma
Did you graduate from this vocational training / other?

Not defined
Continuing Education

Please describe any additional education you are currently enrolled in or completing.
Special Skills

Please list any languages, machine operation, etc., that would be of benefit in a position with NI Industries
Reference 1, Reference 1 Phone*
Reference 1 Relationship to You
Reference 2, Reference 2 Phone*
Reference 2 Relationship to You
Reference 3, Reference 3 Phone*
Reference 3 Relationship to You
Application Terms and Agreement

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false or misleading information, omissions or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time.

If hired. I agree to conform to NI Industries' rules and regulations, and I understand that these rules and/or the employee handbook do not form a contract of employment either express or implied, and I agree that my employment and compensation can be tenninated, with or without cause and with or without notice, at any time, at either my or the NI Industries' option.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by NI Industries.

I understand that no Company representative, other than its president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any special period of time, or to make any agreement contrary to the forgoing.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview.

I hereby waive any any all rights and claims I may have regarding the employer, its agents, employees or representatives for seeking, gathering and using truthful and nondefamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it may be necessary for me to reapply and fill out a new application.
By checking this box, I agree to the statement above, and agree to provide further information, if needed, to NI Industries to process my application.
Signature*

Entering your full name in this box serves as your signature for this electronic application.

Job Application

NI Industries

Job Application

Personal Information

Position

Employment Experience

Education Background

Application Terms and Agreement