Employment Application

Please fill out this application to the best of your ability. Print all information. Answer all questions accurately and completely. Print "N/A" in any space that does not apply to you. We are an equal opportunity employer and do not discriminate on the basis of race, religion, color, sex, age, national origin, disability, genetic information, sexual orientation, gender identity, citizenship status, or marital status. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Required fields designated with an *.

If you prefer to fill out an application by hand, please download the application below. Upon completion, please mail to us at: A.Y. McDonald, Mfg. Co., PO Box 508, Dubuque, IA 52004-0508.

• Download Employment Application.

Positions Applied For:
Date: August 1, 2010

Online Employment Application

First Name*		Last Name*
Address*		Phone*
City*		Cell Phone
State*	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Preferred Phone
Zip*		SSN*
Years at this Address	1 2 3 4 5-9 10-15 15+	Previous Address
State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip*
City		E-mail

Are you lawfully authorized to work in the United States?*	Yes No
Have you ever been convicted of a felony?*	Yes No
If yes, please describe. NOTE: Conviction of a crime will not necessarily disqualify you for employment. Each conviction will be judged on its own merits with respect to time and job relatedness.
Are you over 18 years of age?*	Yes No
How were you referred to A.Y. McDonald?*
Have you ever applied to us before?*	Yes No
If yes, when? Position:
Whom do you know here?	List relatives employed by A.Y. McDonald (give name, relationship and position)
Date available*

 

Education

Years completed (select one)
6 7 8 9 10 11 12 13 14 15 16 17+
High School
Name		City
Address		State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
		Zip
Years Attended		Diploma, Degree or Credits Earned
Major		Minor

College or University
Name		City
Address		State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
		Zip
Years Attended		Diploma, Degree or Credits Earned
Major		Minor

Business, Trade or extension school
Name		City
Address		State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
		Zip
Years Attended		Diploma, Degree or Credits Earned
Major		Minor

 

mechanical

Can you read and work from blueprints?*	Yes No
Can you set your own tools?*	Yes No
Do you have any CNC experience?*	Yes No
Can you read micrometers?*	Yes No

 

Experience

Check or list below the kind of work/equipment you have experience with.

Typing Word Processor Excel Ten Key Adding Machine Word PowerPoint Personal Computer Windows Other Software packages (list below)

Additional Information:

List training seminars or other job related skills:

List the positions that best describe your most significant abilities, training and experience (last position first). If you include volunteer activities, please exclude organizations that might indicate race, color, religion, national origin, disability, genetic information, sexual orientation, gender identity, citizenship status, marital status, age, sex, or other protected status.
BUSINESS ONE
Name		City
Address		State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Phone		Position Held
Supervisor Name		Supervisor Title
Weekly Wages	Starting   Ending	Dates Employed	From   To

Describe significant work experiences	Reason for leaving

BUSINESS two
Name		City
Address		State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Phone		Position Held
Supervisor Name		Supervisor Title
Weekly Wages	Starting   Ending	Dates Employed	From   To

Describe significant work experiences	Reason for leaving

BUSINESS three
Name		City
Address		State	Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Phone		Position Held
Supervisor Name		Supervisor Title
Weekly Wages	Starting   Ending	Dates Employed	From   To

Describe significant work experiences	Reason for leaving

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Please list employers you prefer we NOT contact for references:
Which of the above jobs did you like best & why?
What kinds of work are you now confident you can do satisfactorily?
What annual salary (earnings) would seem reasonably satisfactory to you to start with?*
After one year?

 

authorization

I certify that answers given in this application are true and complete to the best of my knowledge. I authorize investigation into all statements I have made on this application as may be necessary for reaching an employment decision. I understand that A.Y. McDonald Mfg. Co. will attempt to verify statements
made on my application and made during my employment interview.

If I am employed, I understand that any false or misleading information provided in any application or interview(s) may result in discharge if and when discovered. I understand also that if employed, I am required to abide by all the rules and regulations of A.Y. McDonald Mfg. Co.. The completion of this
application does not indicate there are any positions open and does not in any way obligate A.Y. MCDONALD MFG. CO.

This application shall be considered active for no more than 45 days. After that time, applicants will be required to resubmit a completed application.

I UNDERSTAND I WILL NOT BECOME AN EMPLOYEE UNTIL VERIFICATION OF PREVIOUS EMPLOYMENT AND REFERENCES, AND EMPLOYMENT WILL BE CONTINGENT UPON MY SATISFACTORILY MEETING THE PHYSICAL REQUIREMENTS OF THIS JOB AND DRUG FREE STATUS, AS REQUIRED BY THE COMPANY.

I UNDERSTAND THAT ALL EMPLOYMENT HERE IS AT-WILL AND NEITHER THIS DOCUMENT NOR ANY OFFER OF EMPLOYMENT FROM THIS EMPLOYER CONSTITUTES AN EMPLOYMENT CONTRACT UNLESS A SPECIFIC DOCUMENT IS EXECUTED IN WRITING. I UNDERSTAND THAT I HAVE THE RIGHT TO TERMINATE MY EMPLOYMENT AT ANY TIME WITH OR WITHOUT NOTICE, WITH OR WITHOUT CAUSE, AND THAT A.Y. MCDONALD MFG. CO. HAS A SIMILAR RIGHT. I UNDERSTAND THAT NO ONE OTHER THAN THE PRESIDENT HAS AUTHORITY TO MAKE ANY OTHER AGREEMENT AND THAT ANY SUCH AGREEMENT MUST BE IN WRITING.

Signature*
By checking this box, I agree to the terms above and understand this is an electronic consent of authorization. I also understand if elected for an interview, I will be required to endorse this employment application with my written signature.*

Authorization to release employment reference information I, * , understand that A.Y. McDonald Mfg. Co. will attempt to verify statements made on my application
and made during my employment interview. When contacted by this company, I give my permission for my former employers to answer any and all questions based upon information available to them in my prior employment records. I understand that it is possible that my prior employment records may not be accurate. Nonetheless, in consideration of this company’s review of this application, I release this company and all former employers from any liability as a result of furnishing and receiving reference information. I understand that my failure to sign this reference release so the company can contact references and make a full background check of my previous work history will be deemed interference with and a withdrawal of my application for employment.

Yes    No
Place your initials in the appropriate space to indicate and document your consent to this authorization.

Signature*
By checking this box, I agree to the terms above and understand this is an electronic consent of authorization. I also understand if elected for an interview, I will be required to endorse this employment application with my written signature. *