Employment Application CompanyThis field is for validation purposes and should be left unchanged.Applicant InformationFirst Name(Required)Last Name(Required)Today's Date(Required) Street AddressApartment # / SuiteCity(Required)State(Required)Zip(Required)Phone(Required)Email(Required) Date Available(Required) Desired Salary(Required)Position Applied For(Required)Are you a citizen of the United States?(Required) Yes No If not, are you authorized to work in the U.S.? Yes No Have you ever worked for this company?(Required) Yes No If so, when?Have you ever been convicted of a felony?(Required) Yes No If so, when?Within the last 5 years have you been convicted of or released from incarceration for a misdemeanor which was not a first offense for, drunkenness, simple assault, speeding, a minor traffic violation, or disturbing the peace? Yes No EducationHigh SchoolAddressDatesDid you graduate? Yes No DegreeCollegeAddressDatesDid you graduate? Yes No DegreeOtherAddressDatesDid you graduate? Yes No DegreeReferencesFull NameAddressCompanyPhoneRelationshipFull NameAddressCompanyPhoneRelationshipFull NameAddressCompanyPhoneRelationshipWork Experience (Beginning with the current or most recent)CompanyPhoneAddressSupervisorJob TitleResponsibilitiesStarting SalaryEnding SalaryDatesReason for leavingMay we contact your previous supervisor for a reference? Yes No CompanyPhoneAddressSupervisorJob TitleResponsibilitiesStarting SalaryEnding SalaryDatesReason for leavingMay we contact your previous supervisor for a reference? Yes No CompanyPhoneAddressSupervisorJob TitleResponsibilitiesStarting SalaryEnding SalaryDatesReason for leavingMay we contact your previous supervisor for a reference? Yes No Military ExperienceBranchDatesRank at DischargeType of DischargeIf other than honorable, explainEmergency ContactNameRelationshipTelephoneCell PhoneAdditional InformationDisclaimer and SignatureI certify that all answers and statements given by me are true and correct without reservations of any kind and that no attempt has been made by me to conceal pertinent information. I hereby consent to allow Lakeside Metal Specialties, Inc./Lakeside Construction Fasteners, Inc. to perform a background check. If employed, I will comply with all company regulations. I authorize my former employers, schools, and references to give any job-related information they may have regarding me. I hereby release them and their companies from all liability for issuing such information. If upon investigation anything on this application is found to be false, misleading, or detrimental to the company’s operations in any way, I understand that I will be subject to dismissal from employment at any time during my period of employment. Lakeside Metal Specialties, Inc./Lakeside Construction Fasteners, Inc. participates in E-Verify to make employment eligibility determinations in accordance with federal agencies. I fully understand that any offer of employment will be subject to the company’s regulations regarding physical examinations, security investigations, and any other qualifying tests required. If such an investigation and report is made, I understand that I have the right to make a request for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.SignatureDateDO NOT WRITE BELOW THIS LINEInterviewed byHired ByNeatnessAbilityStart DateSalary Lakeside Metal Specialties 6476 AR-135 Paragould, AR 72450 Phone: (870) 586-0147 Fax: (870) 586-0643 Stay Up to Date Subscribe To Our NewsletterJoin our mailing list to receive the latest news and updates from our team. SUBSCRIBE! You have Successfully Subscribed! Our Capabilities Lakeside Metal Specialties supports your manufacturing supply chain, providing cost effective full support solutions. 35+ years of global sourcing experience Inhouse engineering Quality Assurance & Inspection Warehousing in the Central US to support JIT deliveries No hidden costs. Quoted prices include all import / export duties, transportation and administration costs Menu Home About Us Products Services Contact Us Follow Us FollowFollowFollowFollow