Withers Tool, Die & Mfg. Co. Inc.

APPLICATION FOR EMPLOYMENT

Please fill out digital application completely, then click the submit button to apply now, or mail resume to:

Withers Tool, Die and Mfg Co.
1238 Veterans Memorial Hwy
Mableton, GA 30126

*Last Name:
*First Name:
Middle Name:
*Street Address:
*City, State, Zip:
*Home Telephone:
Business Telephone:
Have you ever appliedfor employment with us?	YesxNo
If yes, month and year:
*Social Security Number:
Position Desired:
Pay Expected:
Are you available for full-time work?	YesxNo
If not, what hours can you work?
Will you work overtime if asked?	YesxNo
Are you legally eligible for employment in the United States?
When will you be available to begin work?
Other special training or skills (languages, office machine operaiton, etc.)
Email

Employment Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer; please account for all periods during the last 10 years, including unemployment and service with the U.S. armed forces. We may contact the employers listed below unless you indicate those you do not wish us to contact.
Company Name:	Telephone (include area code):

Address:	Dates employed (Month, Year):
	From:To:
Name of Supervisor:	Weekly Pay:
	Start:Last:
State Job Title and Descibe Your Work:	Reason for Leaving:

Company Name:	Telephone (include area code):

Address:	Dates employed (Month, Year):
	From:To:
Name of Supervisor:	Weekly Pay:
	Start:Last:
State Job Title and Descibe Your Work:	Reason for Leaving:

Company Name:	Telephone (include area code):

Address:	Dates employed (Month, Year):
	From:To:
Name of Supervisor:	Weekly Pay:
	Start:Last:
State Job Title and Descibe Your Work:	Reason for Leaving:

Company Name:	Telephone (include area code):

Address:	Dates employed (Month, Year):
	From:To:
Name of Supervisor:	Weekly Pay:
	Start:Last:
State Job Title and Descibe Your Work:	Reason for Leaving:

Information Withers Tool, Die and Mfg. Co. Inc is an equal opportunity employer. It is our policy to avoid the unfair employment practices prohibited by the Civil Rights Act of 1964. If hired, you will be required to provide proof of your legal right to work in the United States of America.
Are you under 18 years of age? YesxNo		Do you have a valid driver's license? YesxNo
What was your previous address?		How long at previous address? How long at current address?
State names of relatives and friends working for us.

Have you ever been convicted of a crime, other than a minor traffic violation? YesxNo
If yes, describe in full:
Do you have any physical limitations which might limit your job performance for the position for which you are applying? YesxNo
If yes, describe limitation:

Please check any of the following for which you have operational and set-up experience.
	2 Years Or More	Less Than 2 Years		2 Years Or More	Less Than 2 Years
Assembler Bench			Surface Grinder
Assembler Machine			Tool & Die Maker
Bridgeport			Vert. Boring Mill
Engine Lathe			Vert. Milling Machine
Horz. Boring Mill			Electric Welder
Horz. Milling Machine			MIG Welder
CNC Machine Center			TIG Welder
CNC Programming			Welder / Fabricator
NC Tape Drill			Inspection
Planer			Read Blue Prints
Radial Drill
Other Skills:

Single Source for Large Precision Machining & Grinding
Serving the Southeast and Beyond