Employment Application - Bunting Magnetics Co.

Personal Information

Your Name(Required)

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Address(Required)

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Your Email Address(Required)

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Name of Employee who referred you to this position

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Position Desired(Required)

Shift Preference

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Full Time / Part Time

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Desired Salary

Date Available

Are you legally eligible for employment in the U.S.?(Required)

(If offered employment, you will be required to provide documentation to verify eligibility.)

Yes

No

Are you over the age of 18?(Required)

Yes

No

Have you previously worked for Bunting Magnetics Co.?

Yes

No

If so, when?

Work and Education History

Education Information(Required)

Name and Location of School

Course of Study

Years Completed

Diploma or Degree

Have you ever served in any branch of the U.S. Military?

Yes

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If yes, what education or experience might be related to possible employment?

Employment History

Your Previous Employers

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Personal References(Required)

List three persons, other than friends or relatives, who are familiar with your work ability.

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City & State

Phone

Relationship / Years acquainted

Experience and Training

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Please describe any applicable experience and training you may have for the position for which you are applying:

Please describe any supervision/management experience you may have:

Please list any additional information that may be helpful in considering your application (certifications, specialized training, etc):

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(Please read carefully before signing)

In signing and submitting this Application for Employment to Bunting ® Magnetics Co. (“the Company”), I clearly understand and agree to the following statement.

Just as I am free to resign at any time, the Company reserves the right to terminate my employment at any time, with or without cause, and without prior notice. I understand that no supervisor or representative of the Company, except the President, has any authority to make any agreements to the contrary.

If, in the event of employment, I fail to return any tools which I check out, or have purchased through the Company and are unpaid, or if within the first 60 days of employment voluntarily terminate or I am terminated for any reason other than layoff, I hereby authorize the Bunting ® Magnetics Co.to deduct from any wages due me, at the time, the value of such tools, and medical expenses paid on my behalf. I also agree to furnish the personal tools customarily required for my job.

If employed, I agree to abide by the rules, regulations, and policies of the Company now in force or that may be established in the future, and I agree to conduct myself in accordance with them, with full knowledge that violation may mean discipline, including discharge. I also agree to devote my full time to the best interest of the Company.

If requested, I will furnish a doctor’s statement regarding any condition which I may have listed on this application. If accepted for employment, prior to such employment and for the purposes of this application or for the purpose of a medical examination prior to or after I am employed, I authorize my doctor whom I have consulted previously or which I may consult in the future in a physician-patient relationship to release and convey any information to Bunting ® Magnetics Co. relative to such consultation or treatment. Where a medical examination is required, I understand that my final acceptance and job placement is based upon the findings of the examination.

I hereby affirm that the information provided in this application (and accompanying resume, if any) is true and complete to the best of my knowledge, and I agree that misrepresentation, falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date.

I authorize the persons, schools, current and past employers (if applicable), and organizations named in this application (and accompanying resume, if any) to provide Bunting ® Magnetics Co. with any and all information concerning my previous employment and any information they may have, personal or otherwise, and I release all such parties from all liability for any damage or claim that may result from furnishing such information to Bunting ® Magnetics Co.

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