Employment Form

APPLICATION FOR EMPLOYMENT

Walker Products Inc. is an EQUAL OPPORTUNITY EMPLOYER. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law. It is our intention that all qualified candidates be given equal opportunity and that selection decisions be based on job-related information. PLEASE COMPLETE THE APPLICATION IN ITS ENTIRETY. No action will be taken on this application until all questions have been answered. DO NOT WRITE “SEE RESUME” as resumes are not acceptable in lieu of information required on the application. PROVIDE ONLY THE INFORMATION REQUESTED. FAILURE TO DO SO WILL RESULT IN DISQUALIFICATION OF YOUR APPLICATION. Submit a new application for each position for which you are applying. Walker SMS is a drug-free workplace. All employment offers are subject to successful completion of substance screening and a criminal background check.

Today's Date(required)

How did you hear about us?(required)

Last Name(required)

First Name(required)

Middle Initial

Address(required)

City(required)

State(required)

Zip(required)

Home Phone(required)

Cell Phone

Email address(required)

Position Applying For(required)

Based upon the description of the job for which you are applying, are you able to perform all of the essential functions of the job with or without reasonable accommodation? (required)

Yes

Please list any other names you have used

Have you ever been employed by Walker Products? (required)

Yes

If yes, give dates:

Are you 18 years of age or older? (required)

Yes

If hired, can you furnish proof you are eligible to work in the United States? (required)

Yes

Do you have any relatives employed by Walker SMS? (required)

Yes

If yes, name(s):

If required, are you available to work: (required)

Overtime

Weekends

Computer - List systems, software & knowledge level

10–key by touch:

Yes

Keyboarding:

Yes

Speed /WPM

Education - Skills - Abilities

High School

Name of School

Diploma, GED or Degree

Major & Degree Obtained

College

Name of School

Diploma, GED or Degree

Major & Degree Obtained

Trade School

Name of School

Diploma, GED or Degree

Major & Degree Obtained

Apprenticeships, correspondence courses and additional training not shown above

List three persons not related to you who have knowledge of your work performance within the last 5 years.

Name

Address/Phone

Relationship and years acquainted

Name

Address/Phone

Relationship and years acquainted

Name

Address/Phone

Relationship and years acquainted

Attach A Resume

Maximum size 10MB

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I certify that all the information in this employment application is true and correct to the best of my knowledge. I understand that any false statement, misstatement or omission of information will result in disqualification or, if already hired, dismissal from employment, no matter when the misstatement or omission is discovered.

I authorize the investigation of criminal history and any or all statements contained in this application and also authorize, whether listed or not, any person school, current employer, past employer and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

I understand that if I am extended an offer of employment, it may be conditioned upon my successfully passing a complete pre-employment physical examination. I understand that any offer may also be conditioned upon my successfully passing a drug and/or alcohol screening examination. I hereby consent to a pre or post employment drug and/or alcohol screen as a condition of employment if required.

I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESSED OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. I UNDERSTAND THAT ALL EMPLOYMENT WITH WALKER SMS IS AT-WILL, MEANING THAT EMPLOYMENT WITH WALKER SMS MAY BE TERMINATED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT THE OPTION OF EITHER SMS OR THE EMPLOYEE. I UNDERSTAND THAT ONLY THE PRESIDENT OF WALKER PRODUCTS INC. HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE AN AGREEMENT CONTRARY TO THE FOREGOING. I UNDERSTAND THAT ANY SUCH AGREEMENT MUST BE IN WRITING AND SIGNED BY THE PRESIDENT OF WALKER PRODUCTS INC.

Signature(required)

Date

This field should be left blank

Quality • Coverage • Support

APPLICATION FOR EMPLOYMENT

Work Experience

1

2

3

4

Other special skills and abilities relevant to the position for which you are applying:

Education - Skills - Abilities

High School

College

Trade School

List three persons not related to you who have knowledge of your work performance within the last 5 years.

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