Quality Management-Inspection, Rework,Sorting and Containment by Benchmark National Services

General Information

Name (last, first, middle)
Present Address	City	State	Zip Code
Permanent Address	City	State	Zip Code:
Phone No.		Referred by:

Employment Desired

Position	Date You Can Start	Desired Salary
Are You Currently Employed?	If yes, may we contact your present employer?
Have you ever applied to Benchmark before?	If yes, when?

Education

	Name and Location	Years Attended	Did You Graduate?	Subjects Studied
High School
College
Trade, Business or Correspondence

General

Subjects of Special Study / Special Training / Skills

U.S. Military Service

Rank

Have you ever been convicted of a felony? A felony conviction does not automatically exclude you from consideration
If yes, what charges?	When?

References

List the names of three persons not related to you whom you have known at least 1 year.

Name	Address and Phone Number	Business	Years Known

Former Employers

List below your last four employers, starting with most recent.

Month and Year	Name and Address	Salary	Position	Reason for Leaving
From
To
From
To
From
To
From
To

Additional Information

Do you have a valid driver's license?
Can you provide your own transportation to work?
Are you able to stand for extended periods of time and lift up to 40 lbs?
Are you able to drive to locations within 60 miles to work?
Are you willing to submit for a drug test if required?
Do you own safety shoes?
What is your shift preference? (check all that apply)	1st 2nd 3rd

Authorization

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I authorize Benchmark National Corporation to investigate facts stated in this application.

Copyright 1992-2010 Benchmark National Corporation All Right Reserved
3161 North Republic Blvd. Toledo, Ohio 43615 Phone:419.843.6691 Toll Free: 800.637.9536(USA Only) Email:info@benchmark-usa.com Privacy Policy