Gerard Tank & Steel
1540 East 11th St.
Concordia, KS 66901
Phone: 785-243-3895
Fax: 785-243-1804
Email Us
Application For Employment
To Applicant:  We appreciate your interest in our organization and assure you that we are interested in your qualifications.  A
clear understanding of your background and work history will aid us in placing you in the position that best meets your
qualifications and may assist us in possible future upgrading.  Please note that we are an “Equal Opportunity Employer”.
First Name
MI
Last Name
Present Address
Area
Code
Telephone
Number
City
Address
State
Zip Code
Are you legally eligible for employment in the USA?
State age if under 18 or over 70
Do you have reliable transportation to get to work?
Do you have a valid drivers license?
Rate of pay expected
Annual
Position(s) applying for
OR
Per Hour
Specify days and
hours if part time
Are you applying for
Were you previously
employed by us?
If yes, when?
If your application is considered
favorably, on what date will you
be available for work?
Do you have any physical condition which
may limit your ability to perform the
particular job for which you are applying?
What are your experiences, skills, or qualifications which you feel have prepared you for work with our organization?
Have you been convicted of a felony
within the last ten years?
EDUCATION
School
Name and City
of school
Course Of
Study
Check Last Year
Completed
Did you
graduate?
List Diploma or
Degree
High
 
9
10
11
12
 
College
1
2
3
4
Other -
Specify
1
2
3
4
EMPLOYMENT HISTORY
1
Name and Address
of Company
From
To
Describe the
work you did
Weekly
Starting
Salary
Weekly
Ending
Salary
Reason
for
Leaving
Name of
Supervisor
2
Name and Address
of Company
From
To
Describe the
work you did
Weekly
Starting
Salary
Weekly
Ending
Salary
Reason
for
Leaving
Name of
Supervisor
3
Name and Address
of Company
From
To
Describe the
work you did
Weekly
Starting
Salary
Weekly
Ending
Salary
Reason
for
Leaving
Name of
Supervisor
4
Name and Address
of Company
From
To
Describe the
work you did
Weekly
Starting
Salary
Weekly
Ending
Salary
Reason
for
Leaving
Name of
Supervisor
1
2
3
4
If no, indicated by number(s) which
one(s) you do not wish us to contact
May we contact the employers listed above?
Personal References
(not Former Employers or Relatives)
Name and Occupation
Address
Phone Number
By clicking on the submit button I agree  that the facts set forth in my application for
employment are true and complete. I understand that if I am employed, false
statements on this application shall be considered sufficient cause for dismissal. Gerard
Tank & Steel Inc. is hereby authorized to make any investigation of my employment
history.
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