Employment Application

Looking for a few good people...

Lithographics, Inc. is an equal opportunity employer. We are committed to our policy of providing equal employment opportunity to employees and job applicants in a manner consistent with applicable laws and regulations, including federal laws prohibiting employment discrimination on the basis of race, color, religion, national origin, sex, age, disability, or genetic information.

Introductory Information
Name*
First Last
Email*
Address*
Street Address City State ZIP Code
Phone
Applicant Questions
Type of work desired*
Salary desired*
Date available*
Are there any days or shifts you are unable to work?
If hired, can you provide documents required to establish your eligibility to work in the U.S.?
- Yes
- No
Are you 18 years of age or older?
- Yes
- No
How were you referred to Lithographics, Inc.?
Education
--- High School or last grade completed ---
Name of School
School Address
Street Address Address Line 2 City State ZIP Code
High School Course of Study
# Years Completed in High School
Degree/Diploma (High School)
--- College or Technical School ---
Name of College or Technical School
College or Technical School Address
Street Address Address Line 2 City State ZIP Code
College/Tech School Course of Study
# Years Completed in College/Tech School
Degree/Diploma (College or Tech School)
--- Other Schooling or Training ---
Name of Other Schooling or Training
Address of Other School/Training
Street Address Address Line 2 City State ZIP Code
Course of Study (Other School or Training)
# Years Completed in Other Schooling/Training
Degree/Diploma (Other Schooling or Training)
Military Experience
Branch of Service
Rank/Type of Service
Job-Related Training/Experience
Record of Employment
List positions starting with most recent.
Employer
Phone
Position Title
Address
Street Address Address Line 2 City State ZIP Code
Supervisor
Start Date
Date Left
Duties
Reason for Leaving
Employer
Phone
Position Title
Address
Street Address Address Line 2 City State ZIP Code
Supervisor
Start Date
Date Left
Duties
Reason for Leaving
Employer
Phone
Position Title
Address
Street Address Address Line 2 City State ZIP Code
Supervisor
Start Date
Date Left
Duties
Reason for Leaving
Work-Related References
Do NOT include relatives
Work-Related References
Name Occupation Contact Information
Statement
Please read this statement carefully before signing application
Consent
I agree to this statement
I understand that employment with Lithographics, Inc. is at-will, meaning that I or Lithographics, Inc. may terminate my employment at any time, or for any reason consistent with applicable state or federal law.
I authorize Lithographics, Inc. to conduct a thorough background investigation of my work and personal history, and verify all data given on this application and during interviews. I hereby release the Organization, and its representatives or agents, from any liability that might result from such an investigation. I authorize all individuals, schools, and firms named to provide any requested information and release them from all liability for providing the requested information.
I understand that Lithographics, Inc. requires the successful completion of a drug and/or alcohol test as a condition of employment.
I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for employment, I must submit a new application. I certify that all the statements in this completed application are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal to hire.
Your Signature
Date Completed

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Please Call Us: 1-615-889-1200

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Name	Occupation	Contact Information

Employment Application

Looking for a few good people...

Introductory Information

Applicant Questions

Education

Military Experience

Record of Employment

Work-Related References

Statement

Want to talk?

Please Call Us: 1-615-889-1200