Position Applied For *
    Railcar RepairerPaint Department(blaster & painter positions require an applicant to pass a post-offer pre-employment respirator fit physical)Clean Facility(tank car cleaner requires an applicant to pass a post-offer pre-employment respirator fit physical)Other(specify custodian, mechanic, office support staff:)

    First Name *

    Last Name *

    Middle Initial

    Date

    Address *

    City *

    State *

    Zip *

    Phone *

    Email *

    Are you 18 years of age or older? * YesNo


    Are you legally eligible for employment in the United States? * YesNo


    Have you been convicted of a felony within the last 7 years? (Conviction will not necessarily disqualify an applicant from employment) * YesNo

    If yes, please explain


    How did you learn about Midwest Railcar Repair, Inc.? * WebsiteFriend/Relative

    Name of website or friend/relative


    Have you ever been employed with us before? * YesNo

    If yes, please list dates employed


    Have you ever been discharged or asked to resign from a position? * YesNo

    If yes, please explain:


    Do you have a reliable means of transportation to and from work? * YesNo


    Education

    High School

    Name of High School *

    Location of High School *

    Did you graduate? *
    YesNo

    Degree from High School *
    DiplomaGED

    College

    Name of College

    Location of College

    Did you graduate?
    YesNo

    Degree from College

    Trade, Business or Other

    Name of Trade or Business School

    Location of School

    Did you graduate?
    YesNo

    Degree from School


    References

    Please list 2 professional references

    Reference 1

    Full Name *

    Company

    Relationship

    Phone



    Reference 2

    Full Name *

    Company

    Relationship

    Phone

    Work Experience

    Please begin with most recent job held. Give Company name if self employed. Include an explanation for any gaps in employment.

    Experience 1

    Name of Employer *

    Address

    City

    State

    Zip

    Phone

    Name of Supervisor*

    Employed Start Date *

    Employed End Date *

    Salary Start

    Salary Final

    Reason for Leaving *

    Position title and Duties, Skills *

    May we contact Employer? *YesNo



    Experience 2

    Name of Employer

    Address

    City

    State

    Zip

    Phone

    Name of Supervisor

    Employed Start Date

    Employed End Date

    Salary Start

    Salary Final

    Reason for Leaving

    Position title and Duties, Skills

    May we contact Employer? YesNo



    Experience 3

    Name of Employer

    Address

    City

    State

    Zip

    Phone

    Name of Supervisor

    Employed Start Date

    Employed End Date

    Salary Start

    Salary Final

    Reason for Leaving

    Position title and Duties, Skills

    May we contact Employer? YesNo



    Experience 4

    Name of Employer

    Address

    City

    State

    Zip

    Phone

    Name of Supervisor

    Employed Start Date

    Employed End Date

    Salary Start

    Salary Final

    Reason for Leaving

    Position title and Duties, Skills

    May we contact Employer? YesNo


    An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use this space to summarize any additionally information necessary to describe your full qualifications for the specific position for which you are applying. Any gaps in employment may be explained here.


    Questionnaire

    Please check the appropriate skill level and answer the questions to the best of your knowledge.


    Welding

    Cutting Torch NoneSomeSkilled Heating Torch NoneSomeSkilled
    Air Arc Gouge NoneSomeSkilled Plasma Cutter NoneSomeSkilled
    Stick Welding NoneSomeSkilled Flux Core Welding NoneSomeSkilled
    Wire Feed Welding NoneSomeSkilled Aluminum Welding NoneSomeSkilled
    Do you have any experience with LN25 and/or Miller Welders? YesNo


    Hand Tools

    Sockets & Wrenches NoneSomeSkilled Air/Electric Impacts NoneSomeSkilled
    Torque Wrench NoneSomeSkilled Step Jacks NoneSomeSkilled
    Hydraulic Jacks NoneSomeSkilled Chain Hoists NoneSomeSkilled
    Magnetic Sluggers NoneSomeSkilled Huck Equipment NoneSomeSkilled
    Electric Reamers NoneSomeSkilled Porta Powers NoneSomeSkilled
    Grinders NoneSomeSkilled Grinding Wheels NoneSomeSkilled
    Chop Saws NoneSomeSkilled Jack Hammers NoneSomeSkilled


    Heavy Equipment Operation

    Bobcat NoneSomeSkilled Forklift(all-terrain) NoneSomeSkilled
    Crane NoneSomeSkilled Track Mobile NoneSomeSkilled


    Carpentry Tools

    Wood Chisels NoneSomeSkilled Hand Saws NoneSomeSkilled
    Hammer NoneSomeSkilled Measuring NoneSomeSkilled
    Table Saw NoneSomeSkilled Skill Saw NoneSomeSkilled
    Jig Saw NoneSomeSkilled Air Nailer/Stapler NoneSomeSkilled
    Drills NoneSomeSkilled


    Painting/Blasting

    Masking NoneSomeSkilled Paint Pumps NoneSomeSkilled
    What type of Paint Pump?
    Orbital Sanders NoneSomeSkilled What type of blasting equipment?


    General Knowlege

    Please add the following: 1   1/8  +  1  1/2 =
    Please add the following: 1  15/16  +  1   3/8 =
    When heat is applied to steel it contractsexpands
    When using a number 2 cutting tip on a standard oxy/propane cutting torch, set your oxy around and your propane around
    Wire feed welding: What corrections need to be made when your welds have porosity?
    Blueprint Reading NoneSomeSkilled
    Computer Knowledge NoneSomeSkilled
    Computer Programs Used
    Can you work at heights of 14 feet or more? *YesNo
    Can you work in confined spaces? *YesNo


    Applicant's Statement

    I certify that answers given in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on this application or in any interview is sufficient cause for refusal to hire, or dismissal if I have been employed. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at any employment decision. I release from liability any individual or entity involved in such investigation.
    This application for employment shall be considered active for one year. Any applicant not hired during this time period must complete a new application to be considered for employment.
    I understand that my employment is contingent upon passing a post-offer pre-employment screen for illegal drug usage.
    In the event of my employment with the company, I agree to comply with all the company's rules and regulations.
    I further understand that if I am hired, my employment will be "at will" and without fixed term, and may be terminated at any time, with or without prior notice, at the option of either myself or the company.
    I understand the contents of this applicant's statement and hereby acknowledge receipt of this information.

    Enter full name for signature *

    Today's date *

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