APPLICATION FOR EMPLOYMENT

(An Equal Opportunity Employer)

    GENERAL INFORMATION

    Are you related to anyone who works as Akers? if yes, who
    Applying for :
    ManagementProduction SupervisionLogisticsCustomer ServiceAccountingManufacturing
    Referred by :
    Please provide additional referral information (full name of who referred you or agency name)

    EDUCATIONAL INFORMATION

    Circle highest year of school completed
    Did you earn a high school diploma
    High School attended
    City/State
    If you did not competed high school, have you completed your GED?
    Institution Name through which GED was earned?
    City/State
    COLLEGES OR UNIVERSITIES
    Name & Location of School

    Major

    From
    To
    Degree Received

    TRADE, BUSINESS AND SPECIALIZED TRAINING
    Name & Location of School

    Major

    From
    To
    Course Completed?

    EMPLOYMENT INFORMATION

    May we contact your current employer?
    Beginning with the most recent, list below the names and information requested for each employer during the past 7 years.
    Employer
    Employer
    Complete Address
    Complete Address
    Phone#
    Phone#
    From/To
    From/To
    Position
    Position
    Supervisor
    Supervisor
    Wage Rate
    Wage Rate
    Reason for Leaving
    Reason for Leaving
    Employer
    Employer
    Complete Address
    Complete Address
    Phone#
    Phone#
    From/To
    From/To
    Position
    Position
    Supervisor
    Supervisor
    Wage Rate
    Wage Rate
    Reason for Leaving
    Reason for Leaving
    REFERENCES
    Name

    Phone

    Position
    Yrs Known

    APPLICANT'S STATEMENT / RELEASE AUTHORIZATION

    I certify that the information given in this application is true and complete to the best of my knowledge. I authorize Akers Packaging Service, Inc. and/or its representatives to investigate all statements contained in this application as may be necessary in arriving at an employment decision. I understand that any subsequent employment with Akers Packaging service, Inc. is on an at-will basis and may be terminated by either party at any time, for any reason. I also understand that a drug screen analysis is required as a condition of employment.

    I understand that false or misleading information given in my application or interview(s) may prohibit employment or lead to discharge in the event of employment. Further, i expressly authorize by my signature below ay school, government agency, employer and medical organization to release information to Akers Packaging Service, Inc. and/or its representatives.

    Signature