NACCO Application For Employment

An Equal Opportunity Employer

All applicants are considered without regard to race, color, gender, religion, national origin, age, marital or veteran status, mental or physical disability unrelated to job performance or any other legally protected status.

Position Applying For  
Personal Information
Date:

Legal Name: First / Last / Middle Initial (required)

Address: Street / City / State / Zip
Home Telephone:
Other Telephone:
Email (required):
Social Security #:
Drivers License #:
(if position requires operation of a company vehicle)
State:
Are you legally eligible for employment in the United States? Yes:  No:
United States Visa status, if applicable:
If yes, please explain circumstances:
Are you at least 18 years old? Yes:  No:

Position Information

Position(s) Applying for:
Salary Desired: $
Employment Status Desired: Full Time:  Part Time:  Temporary:
What hours are you available to work?:
If hired, when could you start?:
How did you hear about this job?:

Employment History (Most Recent First)

1. Job Title
Duties:
Employer
Dates of Employment (month/year)
From: To:
Starting Salary:
Ending Salary:  
Employers Address:
Supervisor:   May We Contact?  Phone:
Reason For Leaving:
2. Job Title
Duties:
Employer
Dates of Employment (month/year)
From: To:
Starting Salary:
Ending Salary:  
Employers Address:
Supervisor:   May We Contact?  Phone:
Reason For Leaving:
3. Job Title
Duties:
Employer
Dates of Employment (month/year)
From: To:
Starting Salary:
Ending Salary:  
Employers Address:
Supervisor:   May We Contact?  Phone:
Reason For Leaving:
4. Job Title
Duties:
Employer
Dates of Employment (month/year)
From: To:
Starting Salary:
Ending Salary:  
Employers Address:
Supervisor:   May We Contact?  Phone:
Reason For Leaving:

Education

Type of school Name and Location Dates Attended Degree Received Subjects Studied Did you graduate?
High School
College/
University
Graduate
School
Tech
School
Other
Special courses, training or experience acquired, including military experience:

Skills

Clerical / Office skills
Computer Skills (Name of Software) 
Languages
Other special knowledge or skills
Please describe any other experience, abilities or skills that might be helpful in considering your application:

Certification & Authorization

I hereby certify that all statements made in this application are true and correct to the best of my knowledge and belief. I understand that any misrepresentations or omissions of facts in this application are grounds for disqualification from further consideration or for dismissal from employment.
I authorize the company to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position.
If employed, I agree to conform to the rules, regulations and policies of the company. I understand that I will be an employee "at will" and either the company or I may terminate my employment relationship at any time for any reason not in violation of law.
I hereby acknowledge that I have read and fully understand the forgoing and seek employment under these conditions.

Signature of Applicant

Date