You may submit this application by any of the following methods:
• MAIL
Please fill out this electronic copy or print this application, complete it in your
own handwriting (please print), and mail the application along with your resume
to one of the following:
Western US
Eastern US
Northern US
Attn: Brenda York
Attn: Ann Mohns
Attn: Stefany Rowe
Bisco Industries Inc
Bisco Industries Inc
Bisco Industries Inc
1500 Lakeview Ave
150 N. Patrick Blvd., Suite 150
1408 Northland Drive, Suite 301
Anaheim, CA 92807
Brookfield, WI 53045
Mendota Heights, MN 55120
• FAX
Print this application, complete it in your own handwriting (please print), and fax the
application along with your resume to one of the following:
Western US
Eastern US
Northern US
Attn: Brenda York
eFax (714) 876-2403
Attn: Ann Mohns
eFax (714) 876-2489
Attn: Stefany Rowe
eFax (714) 386-3589
• E-MAIL
Complete this application on a computer, and e-mail it along with your resume to:
(see note in section VII.)
Western US
joinus@biscoind.com
Eastern US
onboard@biscoind.com
Northern US
gethired@biscoind.com
• WALK-IN
Print this application, complete it in your own handwriting, and bring it along with
your resume to any of our Bisco locations.
7/31/2013
We are an equal employment employer, dedicated to a policy of non-discrimination in employment on any basis including age,
sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit
performance of essential job functions.
Do not answer any questions with “Refer to resume.”
I.
Personal Information
Name:
Last
First
Middle
Date
Present Address
Permanent Address (if different than above)
Home Phone
Business Phone
Social Security Number
Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of
employment authorization and identity (valid driver's license, birth certificate, Green Card, etc.) within three days of
being hired. Failure to submit proof within the required time shall result in immediate employment termination.
Position Applied For: ___________________________________
1.
Is there any information we would need about your name or use of another name for us to be able to check your work
record? Please specify:
2.
Do you have any relatives who are presently (or have formerly been) employed by Bisco Industries?
3.
4.
How were you referred to Bisco Industries?
Have you ever been convicted of a felony?
II.
___________________________________________________
____ Yes
____ No
If yes, please explain:
Salary
If your application receives favorable consideration, what salary would you require?
Starting $ ________________________________
In one year $ ________________________________
7/31/2013
III.
Employment Record
1.
List the last four employers beginning with the most current
Dates Employed:
Company Name
From
To
Beginning
Ending
Position Held:
Address
Beginning:
May we contact this employer?
Ending:
Telephone
Manager/Supervisor:
Beginning
Salary
Commission
Total
Salary
Commission
Total
Ending
Reason For Leaving ______________________________________________________________________________________
Describe Your Duties _____________________________________________________________________________________
___________________________________________________
What Did You Like Most About This Job? ____________________________________________________________________
___________________________________________________
What Did You Like Least About This Job? ____________________________________________________________________
___________________________________________________
2.
Dates Employed:
Company Name
From
To
Beginning
Ending
Position Held:
Address
Beginning:
May we contact this employer?
Salary
Commission
Total
Salary
Commission
Total
Ending:
Telephone
Manager/Supervisor:
Beginning
Ending
Reason For Leaving ______________________________________________________________________________________
Describe Your Duties _____________________________________________________________________________________
___________________________________________________
What Did You Like Most About This Job? ____________________________________________________________________
___________________________________________________
What Did You Like Least About This Job? ____________________________________________________________________
___________________________________________________
7/31/2013
3.
Dates Employed:
Company Name
From
To
Beginning
Ending
Position Held:
Address
Beginning:
May we contact this employer?
Ending:
Telephone
Manager/Supervisor:
Beginning
Salary
Commission
Total
Salary
Commission
Total
Ending
Reason For Leaving ______________________________________________________________________________________
Describe Your Duties _____________________________________________________________________________________
___________________________________________________
What Did You Like Most About This Job? ____________________________________________________________________
___________________________________________________
What Did You Like Least About This Job? ____________________________________________________________________
___________________________________________________
4.
Dates Employed:
Company Name
From
To
Beginning
Ending
Position Held:
Address
Beginning:
May we contact this employer?
Salary
Commission
Total
Salary
Commission
Total
Ending:
Telephone
Manager/Supervisor:
Beginning
Ending
Reason For Leaving ______________________________________________________________________________________
Describe Your Duties _____________________________________________________________________________________
___________________________________________________
What Did You Like Most About This Job? ____________________________________________________________________
___________________________________________________
What Did You Like Least About This Job? ____________________________________________________________________
___________________________________________________
7/31/2013
IV.
Special Interests
You may omit any activities which may indicate your Race, Religion, Color, National
Origin, Ancestry, Sex or Age
List any extracurricular Clubs or Activities you were involved in during your education: _______________________________
_________________________________________________________________________
Are you currently going to school or involved in any organized Clubs or Activities? If so, please list: _____________________
_________________________________________________________________________
V.
Educational History
School Name/Location
Years Completed
Degree/Diploma
Elem/Jr. High
High School
College
Tech. Training
Other
VI.
Professional References
Please include colleagues, professional mentors, ect. Do not include family.
1.
Name
Years Known
Address
Telephone
Occupation
2.
Name
Years Known
Address
Telephone
Occupation
3.
Name
Years Known
Address
Telephone
Occupation
7/31/2013
VII.
Work Availability
1.
2.
3.
If your application receives favorable consideration, when will you be available to begin work? ___________________
Are you available for full-time work during normal business hours?
( ) Yes
( ) No
Can you travel if required by this position?
( ) Yes
( ) No
VIII. Signature
**Note: If you have completed this application using a computer, by submitting this application you are agreeing that you
understand and accept the following. Otherwise, please sign below.
The information provided in this application is true, correct and complete. If employed, any misstatement or omission
of fact on this application may result in dismissal.
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission
of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may,
regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice.
Signature
Date
7/31/2013