Step 1 of 7 0% Date* Name* First Middle Last Maiden Present Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long?*Social Security Number*TelephoneCell PhoneEmail If under 18, please list agePosition applied for*Salary Desired*Employment Desired* FULL-TIME ONLY PART-TIME ONLY FULL-OR PART-TIME When available for work?* Do you currently have a relative working for Neill-LaVielle or Bearings of Kentucky?*YesNoHave you ever been employed before?*YesNoFrom To Are you legally eligible for employment in this country?*Choose:YesNoWill you travel if the job requires it?*Choose:YesNoWill you work overtime if the job requires?*Choose:YesNoHave you ever pled “guilty” or “no contest” to, or been convicted of a crime?*Choose:YesNo MILITARYHAVE YOU EVER BEEN IN THE ARMED FORCES?*Choose:YesNoARE YOU NOW A MEMBER OF THE NATIONAL GUARD?*Choose:YesNo DO YOU HAVE A DRIVER’S LICENSE?*Choose:YesNoWhat is your means of transportation to work?*Driver’s license #State of IssueAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCommercial (CDL)Expiration Date MM DD YYYY Have you had any accidents during the past three years?*Choose:YesNoHow Many?Have you had any moving violations during the past three years?*Choose:YesNoHow Many? Skills(please check those that apply)Please Check Those That Apply Word Excel Outlook PowerPoint Internet Explorer CNC Porduction Saw CDL Driver's License Forklift Overhead Crane Able to Read Measuring Tape Hazmat 10 Key Typing Personal ReferencesPlease list three personal references that are not related to you.Name First Last TitleRelationship to YouPhoneNumberName First Last TitleRelationship to YouPhoneNumberName First Last TitleRelationship to YouPhoneNumber Education BackgroundHigh SchoolPlease Include Name and LocationYears CompletedCollegePlease Include Name and LocationYears CompletedMajor/DegreeBus. Or Trade SchoolPlease Include Name and LocationYears CompletedMajor/DegreeProfessional SchoolPlease Include Name and LocationYears CompletedMajor/Degree WORK EXPERIENCEPlease list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. 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