Dyersville Die Cast Application Form

Application for Employment at Dyersville Die Cast (DDC)
Dyersville Die Cast is an equal opportunity employer and adheres to the policy of nondiscrimination in employment on any basis prohibited by law. DDC considers applicants for all positions without regard to race, color, religion, gender, national origin, age, disability, marital status, sexual orientation, or any other legally-protected status. Your application will remain active for 60 days.

Incomplete applications will not be considerd. Misinformation provided on this Application and during the hiring process, including ommitted information, is considered as a purposeful act of misconduct, which is also harmful to DDC. Such misinformation shall be a basis for the future termination of your employment.
Personal Information
Full Name*

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Phone Number

Area CodePhone Number

Desired Employment
Desired Position*
Desired Hourly Rate / Salary
Date Available

MonthDayYear
Are you 18 or older?

YesNo
Have you worked here before?

YesNo
Which Department?
If employment is offered, can you produce documentation required by law to establish work authorization and identity?

YesNo
Have you ever been dismissed, involuntarily terminated, or forced to resign from employment?

YesNo
If yes, please explain
Education and Training

High School

	Name of School	Course of Study	Years Completed	Diploma or Degree?
High School
College or University
Graduate or Business School
Trade School or other

Describe any specialized training, licenses, or certifications:
Has any license you have held been surrendered, suspended, or revoked for any reason? If so, please explain:

References

Please provide names of three (3) professional references, not related to you, whom you have worked for or with.
Name

First NameLast Name
Professional Title
Phone Number

Area CodePhone Number
Name

First NameLast Name
Professional Title
Phone Number

Area CodePhone Number
Name

First NameLast Name
Professional Title
Phone Number

Area CodePhone Number
Criminal Background

A conviction, or information as to any arrest that may be obtained by Dyersville Die Cast, will not necessarily disqualify an applicant for the position sought.
Have you ever been convicted of or pleaded guilty or no contest to any violation of any state, federal, county, or municipal law, other than a traffic violation?

NoYes
If yes, please provide information regarding the nature of the charge, the date and location of conviction, the final disposition of the case, and related rehabilitation:
At-Will Employment Disclaimer

Applicant Agreement and Certification of Background Information
I certify that the answers given in this application are true to the best of my knowledge. I understand that the use of this application form does not indicate there are open positions and does not in any way obligate Dyersville Die Cast.

I understand that should I be granted an interview, no representations that are made at the interview are to be construed as creating any obligation, promise, or contract on behalf of Dyersville Die Cast. Further, in consideration of my employment, I agree to conform to the policies and procedures of Dyersville Die Cast as they may be revised or implemented at any time, and that my employment is "at-will" and can be terminated with or without cause at any time for any lawful reason at the option of either Dyersville Die Cast or myself. Such lawful reasons include, but are not limited to, work performance, attitude, ability or willingness to take direction, and conduct with coworkers.

I have applied for employment with Dyersville Die Cast. I authorize investiggation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I authorize representatives of Dyersville Die Cast to obtain pertinent information from my previous employers, references, driving records, licensing status, or professional designation and character or reputation and to consider the information provided by the background check when making decisions regarding my employment at Dyersville Die Cast. I authorize all previous employers, references, or other persons having knowledge of my record or myself to release such information to Dyersville Die Cast, and herby release all persons from liability for any damage that may result from furnishing such information. A photocopy of this authorization may be accepted in lieu of original.

I understand that false, misleading information, or omitted information that I provide in the application or during the hiring process constitutes misinformation, and agree that such misinformation is harmful to Dyersville Die Cast. I also understand and agree that in providing any misinformation I have purposefully misled DDC. Finally, I understand that acceptance for employment shall depend on satisfactory replies from my references and other background checks. In the event I receive a job offer, I also understand that I may be subject to a drug test and/or medical examination that I must pass before I commence work.
I have read, understood, and agree to the information provided above.

Clear
Date

MonthDayYear
Should be Empty:

Application for Employment at Dyersville Die Cast (DDC)

Personal Information

Desired Employment

Education and Training

Employment History

Skills

References

Criminal Background

At-Will Employment Disclaimer