Application for Employment
Metal-Fab Logo
                                 Metal-Fab
                                 3025 May St
                                 PO Box 1138
                                 Wichita, KS 67201-1138
                                 Ph. 316 943-2351
                                 Fax. 316 943-2717
                                 j.o.b.s.@.m.t.l.f.a.b...c.o.m
An Equal Opportunity Employer
An "At Will" Employer
Conditions of employment are stated at the end of this form. Please read carefully before you submit this application.
(Application must be completed in full - * Indicates required fields.)
POSITION APPLIED FOR: *
Other Position:*
DATE:
12-05-2023
*HOW DID YOU HEAR ABOUT US:
*EMPLOYEE NAME: First - Last -
*OTHER REFERRAL:
*EMPLOYMENT AGENCY:
PERSONAL INFORMATION
NAME: First: * Middle: Last: *
PRESENT ADDRESS:  STREET:* CITY:* STATE:* ZIP:* 
PRIMARY PH#:* HOME PH#: WORK PH#: BEST TIME TO CONTACT YOU?:
IF NO PHONE, HOW MAY WE CONTACT YOU?: Email:*
HAVE YOU EVER WORKED FOR METAL-FAB BEFORE? *
IF YES, APPROXIMATE DATE:* (mm/yyyy)
GENERAL INFORMATION
ARE YOU AT LEAST 18 YEARS OF AGE? *
ARE YOU ELIGIBLE FOR EMPLOYMENT IN THE UNITED STATES? *
(if offered employment, you will be required to provide documentation to verify eligiblity.)
DO YOU HAVE A CRIMINAL CONVICTION OR JUVENILE ADJUDICATION FOR A FELONY OR MISDEMEANOR IN THE PAST 7 YEARS? *
IF SO, PLEASE DESCRIBE IN THE BOXES BELOW.
Applicant is not obligated to disclose any reference to a pre or post trial diversion program, any conviction or adjudication which has been sealed, expunged or erased by the court. Conviction or adjudication will not necessarily be a bar to employment. In accordance with company policy and applicable state and federal laws, factors such as age at the time of the offense, remoteness of the offense, time since last conviction or adjudication, nature of the job sought and rehabilitation effort will be reviewed.
INCIDENT CITY/STATE CHARGE
1.*
2.
HAVE YOU EVER BEEN DISCHARGED FROM ANY EMPLOYMENT OR ASKED TO RESIGN? *
IF YES, PLEASE EXPLAIN: *
PLEASE SELECT SCHEDULE AVAILABILITY:* 1st 2nd 3rd
Note: work schedules are based upon the needs of the business and may be subject to change.
WAGE EXPECTED:* $ per: DATE AVAILABLE FOR WORK? / / (mm/dd/yyyy)
EDUCATION
TYPE OF SCHOOL NAME OF SCHOOL
 MAJOR SUBJECT
GRADUATED
YES --- NO
GRADUATION DATE
(mm/yyyy)
DEGREE
DIPLOMA EARNED
HIGH SCHOOL
---
/
CITY/STATE
HIGH SCHOOL
---
/
CITY/STATE
COLLEGE
---
/
CITY/STATE
COLLEGE
---
/
CITY/STATE
VOCATIONAL
---
/
CITY/STATE
VOCATIONAL
---
/
CITY/STATE
OTHER TRAINING
---
/
CITY/STATE
ADDITIONAL EXPERIENCE OR QUALIFICATIONS
List any other experience, skills or other qualifications including hobbies, which you believe should be considered in evaluating your qualifications for employment. Please indicate any prior military service, which you would like to have considered in your application for employment.
ESSENTIAL JOB FUNCTIONS
DO NOT ANSWER THE QUESTION UNLESS YOU HAVE REVIEWED THE JOB DESCRIPTION OF THE POSITION FOR WHICH YOU ARE APPLYING. After reviewing the job description for the position for which you are applying are you capable of performing the essential functions of the position, with or without reasonable accommodation.*
SKILLS
Check the skills or abilities you have which may be applicable to the position you are seeking.
CNC Machine Nail Gun Pallet Jack Filing Supervisor Skills
MIG/TIG Welder Grinder Housekeeping Counting Basic Computer
Decoiler Bender Conveyor Fax/Copy/Shred MS Word
Spot Welding Bander Electrical Facility Maint. Excel
Forklift Shear Measuring Tools Bilingual Comm.
Press Machine Assembly Scanner Powerpoint
Laser Skill Saw Data Entry Multi-Line Phone
Sander Other Saw Typing Math Skills
ATTENDANCE AND PUNCTUALITY INFORMATION
Metal-Fab expects employees to be reliable and to be punctual in reporting for scheduled work each and every day or shift and complete all scheduled hours. Can you meet the above attendance and punctuality requirements? *
IF NO, EXPLAIN. *
EMPLOYMENT HISTORY
ARE YOU CURRENTLY EMPLOYEED?
MAY WE CONTACT YOUR PRESENT EMPLOYER.
DO YOU HAVE AN EMPLOYMENT HISTORY? *
PLEASE ENTER THE INFORMATION REGARDING YOUR PAST EMPLOYMENT:
List all jobs including military service, school, part time employment while in school, self-employment and periods of unemployment over the last ten years beginning with the most recent. Additional pages are available at the front desk for employment history.
JOB#1
COMPANY NAME: *
FROM: * / (mm/yyyy) TO: * / (mm/yyyy)
ADDRESS: *
CITY,STATE, ZIP: *
PHONE#: *
FAX#:
POSITION/TITLE: *
ENDING SALARY$: *
DESCRIPTION OF DUTIES: *
NAME & TITLE OF IMMEDIATE SUPERVISOR: *
REASON FOR LEAVING: *
PLEASE EXPLAIN: *
ARE YOU SUBJECT TO RECALL?: *
JOB#2
COMPANY NAME:
FROM: / (mm/yyyy) TO: / (mm/yyyy)
ADDRESS:
CITY,STATE, ZIP:
PHONE#:
FAX#:
POSITION/TITLE:
ENDING SALARY$:
DESCRIPTION OF DUTIES:
NAME & TITLE OF IMMEDIATE SUPERVISOR:
REASON FOR LEAVING:
PLEASE EXPLAIN:
ARE YOU SUBJECT TO RECALL?:
JOB#3
COMPANY NAME:
FROM: / (mm/yyyy) TO: / (mm/yyyy)
ADDRESS:
CITY,STATE, ZIP:
PHONE#:
FAX#:
POSITION/TITLE:
ENDING SALARY$:
DESCRIPTION OF DUTIES:
NAME & TITLE OF IMMEDIATE SUPERVISOR:
REASON FOR LEAVING:
PLEASE EXPLAIN:
ARE YOU SUBJECT TO RECALL?:
BUSINESS REFERENCES
NAME:*
OCCUPATION:*
TITLE:*
RELATIONSHIP:*
HOW LONG KNOWN:*
HOME PHONE:*
BUSINESS PHONE:*
HOME ADDRESS:*
CITY, STATE, ZIP:*
NAME:
OCCUPATION:
TITLE:
RELATIONSHIP:
HOW LONG KNOWN:
HOME PHONE:
BUSINESS PHONE:
HOME ADDRESS:
CITY, STATE, ZIP:
EEOC - VOLUNTARY SELF-IDENTIFICATION SURVEY
This employer is required to notify all applicants of their rights pursuant to federal labor laws. For further information, please review this notice from the Department of labor: EEO is the Law poster. You may have additional rights pursuant to recent amendments to federal labor laws. Please review these protections from the EEO is the Law Supplement.

This employer is subject to certain nondiscrimination and/or affirmative action record keeping and reporting requirements which require the employer to invite applicants to voluntarily self-identify their race/ethnicity and gender.

*GENDER

I decline to say

*ETHNIC ORIGIN help_outline
ETHNIC OR RACIAL IDENTITY:
Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish Culture or origin regardless of race.
White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.
American Indian or Alaskan Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including for example Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.


I decline to say
VETERAN STATUS
We ask all candidates to provide the information listed below. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information you provide will be kept confidential and may only be used in accordance with applicable federal, state, and local laws and regulations.

*ARE YOU A PROTECTED VETERAN?
I decline to say
VOLUNTARY SELF-IDENTIFICATION OF DISABILITY
We ask all candidates to provide the information listed below. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information you provide will be kept confidential and may only be used in accordance with applicable federal, state, and local laws and regulations.

*Please choose one of the options below:
Yes, I Have A Disability, Or Have A History/Record Of Having A Disability
No, I Don't Have A Disability, Or A History/Record Of Having A Disability
I Don't Wish To Answer
CERTIFICATION AND RELEASE
PLEASE READ BEFORE SIGNING
I CERTIFY THAT ALL ANSWERS BY ME ARE TRUE, ACCURATE AND COMPLETE, AND I UNDERSTAND THAT FALSIFICATION, OMISSIONS, OR MISREPRESENTATIONS OF FACTS CALLED FOR IN THIS APPLICATION OR ANY OTHER ACCOMPANYING OR REQUIRED DOCUMENTS WILL BE CAUSE FOR DENIAL OF EMPLOYMENT OR IMMEDIATE TERMINATION OF EMPLOYMENT, REGARDLESS OF WHEN OR HOW DISCOVERED.

Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

As an equal opportunity employer, Metal-Fab abides by applicable non-discrimination laws and will not unlawfully discriminate against any employee or applicant for employment on the basis of race, religion, color, sex, disability, national origin, ancestry, pregnancy, age, veteran status, genetic information, or any other consideration made unlawful by federal, state, or local laws.

I authorize Metal-Fab, its employees and agents to verify any information contained in this application or any other accompanying and or required documents. I release Metal-Fab, its employees and or agents and anyone from all liability for supplying such information for any damage or claim that may result from furnishing the information to Metal-Fab

Metal-Fab is a Drug Free Workplace and has zero tolerance for illicit drugs or alcohol.

If I am employed by Metal-Fab, I hereby acknowledge that Metal-Fab may request a test for the detection of illicit drugs or for alcohol. I hereby consent to such a test, and authorize the laboratory that performed such sample and testing to inform Metal-Fab of the results of the test. I consent to a Physical Capacity Test and authorize the Clinic that performed the testing to inform Metal-Fab of the results of the test.

Employment at Metal-Fab is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.

If hired, I agree to abide by the rules, regulations and policies of Metal-Fab 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 understand that employment with Metal-Fab is on an "at-will" basis, which means that my employment with Metal-Fab may be terminated by me or the company at any time, with or without notice, and for any reason not prohibited by law. I further understand that no representation, whether oral or written by any representative or agent of the Company, at any time, can constitute a contract of employment. No representative or agent of the Company, has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term or condition of employment other than in a document signed by the President, or to make any agreement contrary to the foregoing. I acknowledge that a telephonic facsimile (FAX) or photographic copy shall be as valid as the original.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me. If I am submitting the Application for Employment online, I agree to the terms of the Certification and Release and agree to sign the Certification and Release at the initial interview if I am selected for an interview.

I understand that this application for employment shall be considered active for a period of time not to exceed 120 days and that if I wish to be considered for employment beyond this time period, I should inquire as to whether or not applications are being accepted at that time.
APPLICANT SIGNATURE: * DATE: 12-05-2023
My electronic signature is the same as my written signature.