Job Application

Maintenance Internship

Internships

STEP 1: Profile Information & Education

Indicates required field

Biographical Information

First Name:

Middle Name:

Last Name:

Preferred First Name:

E-mail Address:

Phone Number:
(ex. 555-222-1922)

Alternate Number:
(ex. 555-222-1922)

Are you at least 18 years of age? Yes No

Present Address:

 

City:

State: Alabama Alaska American Samoa Arizona Arkansas Armed Forces - Americas Armed Forces - Europe/Africa/Canada Armed Forces - Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

ZIP Code:

Permanent Address:

 

City:

State: Alabama Alaska American Samoa Arizona Arkansas Armed Forces - Americas Armed Forces - Europe/Africa/Canada Armed Forces - Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

ZIP Code:

Application Information

Have you applied at NEW Cooperative before? Yes No

Date available to start work:

Starting Wage Desired:

Do you have the legal right to work in the United States? Yes No

Have you been subject to the FMCSRs+ while employed? Yes No

Are you willing to relocate? Yes No

Have you previously worked at NEW Cooperative? Yes No

Employment Type Desired: Full-time Part-time Temporary Fall Seasonal Spring Seasonal

How did you find out about this position?

Have you ever been convicted of a crime other than a simple misdemeanor? Yes No

Do you have any physical or mental condition which would prevent you from performing any of the essential duties of the job for which you are applying? Yes No

If yes, are you requesting that the company make any type of accommodation? Yes No

Education

Select highest year of school completed in each category:

High School: 9 10 11 12

College/University: 1 2 3 4

Graduate School: 1 2 3 4 5

High School:

Name, City, State:

Major Studies:

Did You Graduate? Yes No

Cumulative GPA or Grade Average:

Degree/Major:

Business, Trade or Correspondence:

Name, City, State:

Major Studies:

Did You Graduate? Yes No

Cumulative GPA or Grade Average:

Degree/Major:

College (Undergraduate):

Name, City, State:

Major Studies:

Did You Graduate? Yes No

Cumulative GPA or Grade Average:

Degree/Major:

College (Graduate):

Name, City, State:

Major Studies:

Did You Graduate? Yes No

Cumulative GPA or Grade Average:

Degree/Major:

Other Information:

Scholastic Honors, Scholarships, Assistantships, ECT.

Certifications:

Attending School Now? Yes No

If yes, where?

List subjects of special study or training:

Foreign language proficiency: