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Smitty’s Supply Inc.
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WE THANK YOU FOR YOUR INTEREST IN SMITTY'S SUPPLY!

Hi there, we're glad to see you! Feel free to take a few minutes and fill out the application below to the best of your ability. If you need further assistance, contact our Human Resources Department with any questions you may have concerning your application. Please give us a few days to process your application. We will be in touch with you just as soon as we are able. Have a great day!!

Current Available Positions

Positions in Roseland, LA: Line Operator, General Labor, Warehouse Operator, Rework, Forklift Operator,
Positions in Independence, LA: Packer, Security Guard

APPLICATION FOR EMPLOYMENT

Application For Employment

Today's Date(Required)

MM slash DD slash YYYY

Position(s) applied for(Required)

How did you learn about us?(Required)

Name(Required)

First Middle Last Suffix

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Home Phone

Mobile Phone(Required)

Email Address

If you are under the age of 18, can you provide required proof of your eligibility to work?(Required)

Do you possess a valid driver’s license? If yes, give list state & number:(Required)

State / Number

Have you ever been employed with us before? If yes, give date:(Required)

Date

MM slash DD slash YYYY

Do any of your friends or relatives work here? If yes, state name:

Friends Name

Are you currently employed?(Required)

May we contact your present employer?(Required)

Are you prevented from lawfully becoming employed in this country because of Visa or immigration status?(Required)

*Proof of citizenship or immigration status will be required upon employment.

Date available for work:(Required)

MM slash DD slash YYYY

What is your desired salary range?(Required)

Are you available to work shift work? If yes, indicate day or night:(Required)

If hired, would you have transportation to/from work?(Required)

Have you been convicted of a felony within the last 7 years?(Required)

Resumé

Max. file size: 100 MB.

Cover Letter

Max. file size: 100 MB.

If yes, explain:

EDUCATION

Name of High School

Course of Study

Years Completed

Diploma/Degree

Undergraduate/ College

Course of Study

Years Completed

Diploma/Degree

Graduate/ Professional

Course of Study

Years Completed

Diploma/Degree

Other (Specify)

Course of Study

Years Completed

Diploma/Degree

COMPUTER SKILLS/ EQUIPMENT OPERATED

COMPUTER SKILLS

Excel

Word

Access

PowerPoint

Publisher

Quickbooks

EQUIPMENT OPERATED

Forklift

Label Machine

Filling Machine

Palletizer

Box Packer

Orientor

Route Truck

Other

Describe any specialized training, skills and extra-curricular activities.

WORK EXPERIENCE (3 Previous Employers)

Employer #1 (Company Name)

Supervisor

Contact Number

May We Contact Them?

Address (Street, City, State, ZIP)

Date Started

MM slash DD slash YYYY

Date Ended

MM slash DD slash YYYY

Reason For Leaving

Start Pay ($)

End Pay ($)

Work Performed

Employer #2 (Company Name)

Supervisor

Contact Number

May We Contact Them?

Address (Street, City, State, ZIP)

Date Started

MM slash DD slash YYYY

Date Ended

MM slash DD slash YYYY

Reason For Leaving

Start Pay ($)

End Pay ($)

Work Performed

Employer #3 (Company Name)

Supervisor

Contact Number

May We Contact Them?

Address (Street, City, State, ZIP)

Date Started

MM slash DD slash YYYY

Date Ended

MM slash DD slash YYYY

Reason For Leaving

Start Pay ($)

End Pay ($)

Work Performed

ADDITIONAL INFORMATION & AGREEMENT

State any additional information you feel may be helpful to us in considering your application.

APPLICANT’S CERTIFICATION(Required)

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Smitty’s Supply, Inc. to verify their accuracy and to obtain reference information on my work performance. I hereby release Smitty’s Supply, Inc. from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

EMPLOYMENT AGREEMENT(Required)

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that either the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.

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+1 (800) 256-7575 • 63415 Hwy. 51 N. Roseland, LA 70456, USA • sales@smittysinc.net