Employment Application - LS Tractor USA

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email(Required)

Phone(Required)

Position Desired(Required)

Salary Desired(Required)

Date Available

Do you have any relatives working for LS Tractor USA or LS Mtron?

Yes

No

If yes, who?

Have you ever been employed by LS Tractor USA or LS Mtron?

Yes

No

Are you 18 years of age or older?

Yes

No

How were you referred to the Company?

Are you legally authorized to work in the United State?

Yes

No

Proof of legal right to work in the United States will be required upon employment.

High School

School Name

Course of Study/Major

Number of Years Attended

Did you Graduate?

Degree Received

Undergraduate

School Name

Course of Study/Major

Number of Years Attended

Did you Graduate?

Degree Received

Graduate

School Name

Course of Study/Major

Number of Years Attended

Did you Graduate?

Degree Received

Additional Education

Certifications, Licenses, and Special Skills

Employment 1

Company

Start of employment

End of employment

Base Salary (specify per hour or yearly)

Job Title and Briefly Describe Your Duties

Name and title of supervisor

May we contact this employer for references?

If yes, please provide a phone number

Employment 2

Company

Start of employment

End of employment

Base Salary (specify per hour or yearly)

Job Title and Briefly Describe Your Duties

Name and title of supervisor

May we contact this employer for references?

If yes, please provide a phone number

Employment 3

Company

Start of employment

End of employment

Base Salary (specify per hour or yearly)

Job Title and Briefly Describe Your Duties

Name and title of supervisor

May we contact this employer for references?

If yes, please provide a phone number

Certification and Release

Consent(Required)

Please read the following statements carefully. This application must be signed to receive consideration for employment.

*I understand that the current use of illegal drugs or illegally used drugs would prohibit me from being employed at this Company. I understand that an offer of employment is contingent upon the successful completion of a drug test. By submitting this Application for Employment, I hereby consent to this test as a condition of employment.

*If employed by LS Tractor USA, I will provide satisfactory proof of my identity and authorization to work in the U.S. in accordance with the Immigration Reform and Control Act.

*I authorize LS Tractor USA to verify the information that I have provided in this application, including references, and to conduct such investigation into the facts surrounding my application as it may deem appropriate. I understand that employment is conditional based upon the results of references, background investigation that may be conducted through any investigative agency of the Company's choice and may include inquiries with my present and/or former employers, educational institutions and references concerning my background, employment history and any other pertinent information and records. I release all parties from any liability whatsoever resulting from such disclosure.

*I understand that if employed by LS Tractor USA I will abide by its policies and practices, which may be amended at the Company's discretion.

*I understand that my employment is not to be construed as an employment contract. If I am offered employment, it will be as an employee-at-will and my employment with the Company may be terminated at any time, with or without cause, and with or without advance notice at the option of either the Company or by me. I also understand that no Company, representative has any authority to enter into any express or implied contract for employment for any specified period of time.

*If employed, I agree to hold in strictest confidence any information concerning the Company and its business operations, products and other proprietary information and understand that offers of employment are contingent upon signing and agreeing to the terms of the Company's Confidentiality Agreement.

I hereby acknowledge that I have read the above statements and understand them. I certify that the information provided by me in this application is true and complete. I understand that any falsification, omission or mis-representation made by me on this application (and accompanying resume or other documents) is grounds for refusal to hire, or if hired, termination of my employment.

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Name

Phone

Current position of reference

How do you know this reference?