Application for Employment

Oshkosh Coil Spring is an Equal Opportunity Employer. Qualified applicants are considered for all positions applied for without regard to race, color, religion, gender, national origin, age, marital status, veteran status or disability.


Personal Information First Name:   Middle Name:   Last Name:
Present Address Street:   City:   State:   How Long?
Previous Address Street:   City:   State:   How Long?
Previous Address Street:   City:   State:   How Long?

Email Address:

Telephone #:   Cell Phone #:

Best time to call?

What position are you applying for?

Are you able to perform the essential job functions of the position for which you are applying?

Explain possible accommodations required:


Have you filled out an application here before?

What prompted you to apply to our company?


Are you presently employed?   If so, may we contact your present employer?

When will you be available?

What type of work are you applying for?   Full-Time     Part-Time     Temp

What shift are you willing to work?   1st Shift     2nd Shift     3rd Shift

If applying for Part-Time, what days are you available?


Education / Work History Please indicate last grade completed:

Name of last school attended: City: State:

Degree obtained:

List special skills and qualifications acquired to perform the job applied for:


Please provide 3 references (Supervisors). Personal friends are NOT considered a reference!

Name:   Phone #:   Position:

Name:   Phone #:   Position:

Name:   Phone #:   Position:

Last Employer Company Name:

Street:   City:   State:   Zip:

Telephone #:

Dates Employed:   From:   To:   Position:   Salary:

Reason for leaving?   Last Supervisor:
2nd Last Employer Company Name:

Street:   City:   State:   Zip:

Telephone #:

Dates Employed:   From:   To:   Position:   Salary:

Reason for leaving?   Last Supervisor:
3rd Last Employer Company Name:

Street:   City:   State:   Zip:

Telephone #:

Dates Employed:   From:   To:   Position:   Salary:

Reason for leaving?   Last Supervisor:
4th Last Employer Company Name:

Street:   City:   State:   Zip:

Telephone #:

Dates Employed:   From:   To:   Position:   Salary:

Reason for leaving?   Last Supervisor:
5th Last Employer Company Name:

Street:   City:   State:   Zip:

Telephone #:

Dates Employed:   From:   To:   Position:   Salary:

Reason for leaving?   Last Supervisor:
Have you ever been denied a permit license or Privilege to operate a motor vehicle?

Has your license been suspended or revoked?

If yes, explain

Any traffic accidents with the last 5 years?

If so, what happened, where, injuries?


List any traffic convictions and forfeitures over the last 5 years (not parking):

Have you served in the U.S. Armed Forces?   Branch:

Rank at Discharge:   Reserve Status



Supporting Documents Submit a Cover Letter Here (Type or Copy & Paste):

Submit a Resume Here (Type or Copy & Paste):

I certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I agree that the company shall not be held liable in any respect if my employment is terminated because of false statements in this application. I understand that falsified statements on this application in any detail shall be considered sufficient cause for disqualification from further consideration for hire of for dismissal.

I authorize the company to make any investigation of my personal or employment history and authorize any former employer, person, firm, corporation, or government agency to give the company any information they may have regarding me. In consideration of the company's review of this application, I release the company and all providers of information from any liability as a result of furnishing and receiving this information.

I understand that I may be required to pass a pre-placement medical examination and/or drug screen and I release the company and its employees from any and all liability or damages resulting from the pre-placement process.

I further agree that, if employed, my employment can be terminated with our without cause, and with our without notice, at any time, at either the company's or my option. I understand that any employment manuals or handbooks that may be distributed to me during the course of my employment shall not be construed as a contract or contract by implication.

Check here to agree to the above statement

Please re-enter your Full Name:

Today's Date: