Careers Miller Industrial Manufacturing is an equal opportunity employer and we welcome applications from qualified potential employees. We are proud to offer a comprehensive benefits package including: Competitive Salaries 401(k) Match Fully Paid Health Insurance Vision and Dental Insurance Profit Sharing Paid Vacation JOB APPLICATION Employment Application Section-1: Applicant Information Full Name * Full Name First First Middle Middle Last Last Email * Address * How long have you lived at this address? * Phone * If under 18, please list your age Desired Salaray (range) * Can you you work nights? * Yes No Employment desired * Full time Part time When available to start work? Section-2: Applicant Education Name of High School Address of High School Attended (From): Attended (To): Did you graduate (High School)? * Yes No Diploma (High School) Section-3: Applicant Education (college) Name of College College address Attended (From): Attended (To): Did you graduate (college)? Yes No Major and Degree (College) Section-4 Education (Other) Name of (Other): Address (Other): Attended (From): Attended (To): Major and Degree (Other) Did you graduate (Other)? Yes No Next Section-5: References Please list three references Reference #1 Name Name First First Last Last Relationship Phone Email Company/Organization Address Reference #2 Name Name First First Last Last Relationship Phone Email Company/Organization Address Reference #3 Name Name First First Last Last Relationship Phone Email Company/Organization Address Section Buttons Next Section-6: EMPLOYMENT Please list your three most recent places of employment (Company-A) Company Phone Supervisor Supervisor First First Last Last Address Job Title Starting Salary ($) Ending Salary ($) Responsibilities From To Reason for leaving May we contact your previous supervisor for a reference? Yes No (Company-B) Company Phone Supervisor Supervisor First First Last Last Address Job Title Starting Salary ($) Ending Salary ($) Responsibilities From To Reason for leaving May we contact your previous supervisor for a reference? Yes No (Company-C) Company Phone Supervisor Supervisor First First Last Last Address Job Title Starting Salary ($) Ending Salary ($) Responsibilities From To Reason for leaving May we contact your previous supervisor for a reference? Yes No Section Buttons Next Section-7: Military Have you ever been in the armed forces? Yes No Are you now a member of the National Guard? Yes No Specialty Discharge Date Section Buttons Section-8: Skills Other specialized training and skills Section Buttons Next Next Section-9: Emergency Contact In case of accident or illness, please contact: * In case of accident or illness, please contact: First First Last Last Daytime Phone * Relationship * Address * Section Buttons Next Next Signature I certify that the statements made by me on this application are true and complete to the best of my knowledge and are made in good faith. I understand that if I knowingly make any misstatement of fact, I am subject to disqualification and dismissal and to such other penalties as may be prescribed by law or personnel regulations. All statements made on this application, including employment information, are subject to verification, as a condition of employment. I certify... * I certify that my answers are true and complete to the best of my knowledge Section Buttons Text If you are human, leave this field blank. Submit When you need the job done right, the first time. Request a Quote
