Careers with Vision Quality Components, Inc.

Applicant Information

Your Name (required)

Social Security Number (required)

Street Address (required)

City (required)

State or Province (required)

Zip Code (required)

Email Address (required)

Phone Number (required)

Eligibility

If you become employed by VISION QUALITY COMPONENTS, can you provide proof of your right to remain and work in the United States? (required) YesNo

If you are under 18 years of age, please state your age.
Your Age

Have you ever been convicted of a crime other than a minor traffic violation? (A conviction record does not necessarily bar employment). YesNo

If yes, please list crimes and date of convictions.

Job Position Details

What position are you applying for? (required)

What other position would you consider? (required)

Please list your shift preferences: (required)

First shift: 7am-3pmSecond shift: 3pm-11pmThird shift: 11pm-7am

Date Available?

Salary Desired?

Referred to VISION by?

Have you ever applied at VISION before? YesNo

If yes, please state when.

Emergency Contact

In case of emergency notify:

Emergency Contact Name (required)

Emergency Contact Phone Number (required)

School

High School

Name of School

Location

Last Grade Completed

Degree / Diploma

College

Name of School

Location

Last Grade Completed

Major

Degree / Diploma

Graduate School

Name of School

Location

Major

Degree / Diploma

Trade, Business, or Correspondence School

Name of School

Location

Last Grade Completed

Major

Degree / Diploma

List any special skills:

Employment Record

List your last three employers, starting with the last or current employer first.

Last or Current Employer

Name of Previous Employer

Street Address

City, State

Zip Code

Company Phone Number

May we contact? YesNo

Supervisor

Your Position

List your duties & responsibilities:

Employment Dates
From:
To:

Starting Salary

Ending Salary

Reason(s) for Leaving:

Previous Employer

Name of Previous Employer

Street Address

City, State

Zip Code

Company Phone Number

May we contact? YesNo

Supervisor

Your Position

List your duties & responsibilities:

Employment Dates
From:
To:

Starting Salary

Ending Salary

Reason(s) for Leaving:

Previous Employer

Name of Previous Employer

Street Address

City, State

Zip Code

Company Phone Number

May we contact? YesNo

Supervisor

Your Position

List your duties & responsibilities:

Employment Dates
From:
To:

Starting Salary

Ending Salary

Reason(s) for Leaving:

Fill in more employment history here if you need extra space.

Attach a Resume

Your Resume (You may attach PDF, DOC, or DOCX files.)

Applicant Statement

I certify that all the information I have provided in order to apply for secure work with the employer is true, complete, and correct. I understand that any information that is provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in the application, resume, or job interview. I hereby waive any rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering, and using such information in the employment process and all other persons, corporations, or organizations for furnishing such information about me. I understand that the employer does not unlawfully discriminate in employment, and no question on this application is used for the purpose limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state, or federal law. I understand that this application remains current for only ninety days. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract of employment for any specified period or definite duration. I understand that no supervisior or representative of the employer is authorized to make any assurances to the contrary, and that no implied, oral or written agreements contrary to the foregoing express language are valid. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement.