Economy Systems Inc. - Application for Employment

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It is the policy of Economy Coating Systems, Inc. to assure that applicants are employed, and that employees are treated during employment, without regard to their race, religion, sex, color, national origin, age, disability, or any other classification protected by federal, state or local laws. Such actions shall include: employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship, pre-apprenticeship and/or on-the-job training.   EEO/AA

Personal Information Last Name First Name Middle Initial Address City State Zip Code Phone Number (ie: 555-555-5555) Email Address Position you are qualified for Grit Blast Painter/Finishing Waterblast/Touch-up Welder/Fabricator Car Repair Switch Crew General Labor Other: Have you filed an application with us before? Yes No Have you worked with us before? Yes No If yes, when and in what position: Do you have a valid driver's license? Yes No Do you have a valid CDL License? Yes No Are you legally eligible for employment in the United States? Yes No Have you ever been convicted of a felony? Yes No If yes, please explain: Shift Desired: 1st (6a-2:30p M-F) 2nd (2:30p-10p M-F) 3rd (10p-6a M-F) Any Shift Date you can start: Rate of pay desired: Name/Relationship of friends or relatives in our employ: Emergency Contact: Name Relationship Phone Number

Current Employer Dates Employed Name of Employer Salary Position Address City State Zip Code Phone Number (ie: 555-555-5555) Supervisor's Name Reason for leaving Previous Employers 1 Dates Employed Name of Employer Salary Position Address City State Zip Code Phone Number (ie: 555-555-5555) Supervisor's Name Reason for leaving 2 Dates Employed Name of Employer Salary Position Address City State Zip Code Phone Number (ie: 555-555-5555) Supervisor's Name Reason for leaving

Education Name & Location of School Years Completed Attained High School Diploma GED College/Tech Diploma Degree Other Diploma Degree References Name Address Phone Number How did you learn about Economy Coating Systems, Inc. ? Newspaper  Employment Agency  Job Fair Walk In  Friend/Relative Search Engine:   Other: Please list and explain any skills you have learned or used, certifications you've earned, advancements or promotions you have earned at any of your prior places of employment:

Skills Please Check the Appropriate Skill Level and Answer the Questions to the Best of your Knowledge Hand Tools Tool Skill Level Sockets and Wrenches     None     Some     Skilled Hammer     None     Some     Skilled Torque Wrench     None     Some     Skilled Air/Electric Impacts     None     Some     Skilled Air/Electric Grinders     None     Some     Skilled Grinding Disc/Abrasive Wheel     None     Some     Skilled Reciprocating Saw     None     Some     Skilled Circular Saw     None     Some     Skilled Jig Saw     None     Some     Skilled Table Saw     None     Some     Skilled Radial Arm Saw     None     Some     Skilled Chop Saw     None     Some     Skilled Hydraulic Jacks     None     Some     Skilled Chain Hoist     None     Some     Skilled Air/Electric Drill     None     Some     Skilled Air DA Sander     None     Some     Skilled Rivet Gun     None     Some     Skilled Huck Tool     None     Some     Skilled Porta-Power     None     Some     Skilled Blow Gun     None     Some     Skilled Scrapers     None     Some     Skilled Wire Brush     None     Some     Skilled Tape Measure     None     Some     Skilled Radial Arm Saw     None     Some     Skilled

Skills continued Please Check the Appropriate Skill Level and Answer the Questions to the Best of your Knowledge Welding Tool Skill Level Cutting Torch(oxy/acy)     None     Some     Skilled Heating Torch     None     Some     Skilled Stick Welding     None     Some     Skilled Flux Core Welding     None     Some     Skilled Wire Feed Welding     None     Some     Skilled Aluminum Welding     None     Some     Skilled Plasma Cutter     None     Some     Skilled Air Arc Gouge     None     Some     Skilled Painting: Tool Skill Level Masking     None     Some     Skilled Paint Pumps     None     Some     Skilled What Types/Brands:     Holiday Detector     None     Some     Skilled Wet Film Thickness Gauge     None     Some     Skilled Dry Film Thickness Gauge     None     Some     Skilled Sling Psychrometer     None     Some     Skilled PH Tester     None     Some     Skilled Surface Profile Gauge     None     Some     Skilled Thermometer     None     Some     Skilled Digital Temperature Recorder     None     Some     Skilled Paint Brush     None     Some     Skilled Paint Roller     None     Some     Skilled Water Blasting: Tool Skill Level Pressure Washers     None     Some     Skilled What types/brands/PSI:

Skills continued Please Check the Appropriate Skill Level and Answer the Questions to the Best of your Knowledge Blasting Tool Skill Level Surface Profile Gauge     None     Some     Skilled What type of Blasting equipment have you used: List types of abrasives you have used: What is the highest pressure you have blasted with: Heavy Equipment: Tool Skill Level Track Mobile     None     Some     Skilled Diesel Air Compressor     None     Some     Skilled Skid Loader     None     Some     Skilled Front End Loader     None     Some     Skilled Vacuum Truck     None     Some     Skilled Sit-Down Forklift     None     Some     Skilled Scissor Lift     None     Some     Skilled Semi Tractor/Trailer     None     Some     Skilled Crane     None     Some     Skilled Operate Manual Transmission     None     Some     Skilled General Knowledge: Please complete the following: 49+87= 63-28= 29x13= 136/16= 1-3/8 + 1-3/4= 1-5/16 - 1-5/8= When heat is applied to steel it: Expands  Contracts When cutting with a number 2 tip on a standard oxy/propane cutting torch, set your oxy around     and your propane around When wire feed welding, what corrections need to be made when your welds have porosity (pin holes): Computer Knowledge:None     Some     Skilled Computer programs you have used: Blueprint reading:None     Some     Skilled

Skills continued Can you work at heights of 12 feet or more: Yes    No Are you claustrophobic or uncomfortable working in confined spaces: Yes    No Can you work off of ladders: Yes    No Are you cabable of satisfactorily performing the essential job duties of the position for which you are applying, with or without reasonable accomodation: Yes    No     Applicant's Statement By submitting this electronic application, I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may be terminated at any time with or without cause or previous notice. I also acknowledge that if I am employed, I am required to abide by all rules and regulations of the employer. I hereby acknowledge that I have read the Drug Testing Policy of Economy Coating Systems, Inc. and I agree to familiarize myself with the policy. I understand that any offer of employment is conditioned on my submitting a sample for drug testing and if the test results are confirmed as not negative, any offer of employment will be immediately withdrawn.

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copyright 2010 Economy Systems Inc.