Contact : Western Integrated Materials

	Yes	No
Do you have friends or relatives employed by Western Integrated Materials? If yes, please provide their names and relationship to you: Relationship	Yes	No
Have you ever been employed here before? If yes, give approximate dates: Start Date - End Date	Yes	No
If hired, do you have a reliable means of transportation to and from work?	Yes	No
If hired, would you be able to travel or work overtime as needed?	Yes	No
Are you able to perform all the essential functions of the job for which you are applying with or without reasonable accommodation?	Yes	No
Do you have a legal right to be employed in the U.S.? (If yes, proof is required)	Yes	No
Are you of legal age to work?	Yes	No
Do you have a valid driver’s license? Exp. Date: Expiration Date State of Issue: State of Issue	Yes	No

All fields below are required. Applicants may be subject to an employment entrance exam that may include screening for illegal drugs. Applicants who confirm positive on drug screening will not be considered for employment. If a job offer is made, it may be made contingent upon the successful passing of a physical.

I CERTIFY that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, false, misleading or incomplete statements on this application shall be grounds for dismissal. I AUTHORIZE Western Integrated Materials to investigate information concerning my previous employment, education and background as well as criminal background, driving record and credit report. I further release all parties from all liability for any damage that may result from furnishing or receiving such information. I UNDERSTAND and agree that my employment is At-Will and compensation may be terminated at any time without prior notice, with or without cause, at the option of Western Integrated Materials or myself, and understand that no representative of Western Integrated Materials, other than the Chief Executive Officer, has authority to enter into any agreement contrary to the foregoing. I UNDERSTAND that all Western Integrated Materials property must be returned and any indebtedness to Western Integrated Materials must be paid on or before my last day of work. I authorize Western Integrated Materials to deduct from my final paycheck an amount necessary to satisfy any unpaid obligation.

Employment Application

Latest News