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Employment Application

Baltimore Hydraulics, Inc. is an equal opportunity employer and does not discriminate in its employment practices on the basis of age, race, sex, religion, national origin, marital status, veteran status, disability, or any other legally protected condition.

Date (required)

Personal

First Name (required):

Middle (required):

Last Name (required):

Street Address (required):

City (required):

State (required):

Zip (required):

Telephone (required):

Your email address (required):

Position Desired:

Pay Expected:

Are you legally eligible for employment in the United States? Yes No
Apart from absence for religious observance, are you available for fully-time work? Yes No
Will you work overtime if asked? Yes No

Schedule you would consider?
Full time: (40 hours per week) Yes No
Part time: (less than 30 hours per week) Yes No
Temporary: (on-call of short-term assignments) Yes No

Indicate the days & hours you are available for work:

When will you be available to start work?

Other special training/skills (languages, machine operation, etc.)
Typing: Yes No
Ten Key Adding Machine Yes No
Calculator: Yes No
CRT/Computer: Yes No
Other Training/Skills:

How were you referred to BHI?
Classified Advertisement (indicate publication & date):

Referral from an employee (indicate employee's name):

Other:

Do you have any relatives employees by BHI? Yes No
if yes, complete the following:
Name:

Relationship:

Department:

In case of emergency, please notify:
Name:

Address:

Relationship:

Education

High School
Name and location of school:

Dates attended:
to
Did you graduate Yes No
Degree or diploma earned, or major course of study:



Business/Trade/Techinical
Name and location of school:

Dates attended:
to
Did you graduate Yes No
Degree or diploma earned, or major course of study:



College
Name and location of school:

Dates attended:
to
Did you graduate Yes No
Degree or diploma earned, or major course of study:



Graduate
Name and location of school:

Dates attended:
to
b Yes No
Degree or diploma earned, or major course of study:

Employment

Company Name:

Address:

Name of Supervisor:

Telephone:

Employed from:
to
Weekly pay:

Job title and description of work:

What job training did you receive:

Reason for leaving:



Company Name:

Address:

Name of Supervisor:

Telephone:

Employed from:
to
Weekly pay:

Job title and description of work:

What job training did you receive:

Reason for leaving:



Company Name:

Address:

Name of Supervisor:

Telephone:

Employed from:
to
Weekly pay:

Job title and description of work:

What job training did you receive:

Reason for leaving:



Company Name:

Address:

Name of Supervisor:

Telephone:

Employed from:
to
Weekly pay:

Job title and description of work:

What job training did you receive:

Reason for leaving:

Military

Did you serve in the U.S. Armed Forces? Yes No
Describe any training received relevant to the position for which you are applying:

Memberships

List any memberships in professional or civic organizations (please exclude those which may disclose your race, color, religion, or national origin):

References

Name:

Address:

Number:

Occupation:



Name:

Address:

Number:

Occupation:



Name:

Address:

Number:

Occupation:

Notice

Under Maryland law an employer may not require or demand any applicant for employment or prospective employment or any employee to submit to of take a polygraph, lie detector or similar test or examination as a condition of employment. Any employer who violates this provision is guilty of a misdemeanor and subject to a fine not to exceed $100.

Signature

I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal.

I authorize any of the persons or organization in this application to provide any information they possess with regard to any of the subject covered by this application and release all such parties from any liability for any damage that may result from furnishing such information. I further authorize the investigation of my credit background and acknowledge that should such a report be contained I will be informed and provided the name and address of the reporting agency.

I understand that no representative of the company has the authority to enter into any agreement for employment for any specified period of time or to assure any other personnel action either to commencement or employment or after I have become employed, or to assure any benefits or terms and conditions of employment, or make any agreements contrary to the foregoing.

If I become employed I agree to abide by the rules and regulations of the company.

Date (required):

Applicant's Signature (required):