Application for Employment

Merrill Iron & Steel, Inc.

900 Alderson Street
P.O. Box 110
Schofield, WI 54476

As an Equal Opportunity Employer, this organization does not discriminate on the basis of race, color, religion, sex, national origin, age, disability or veteran status. All information provided in this application will be treated confidentially and will be used only to help ensure the best use of your abilities if we employ you.
Date of this Application:
Please check the location(s) of interest to you:
Position(s) applied for:      
How were you referred to us?
Name:   Email:
Home Phone: Cell Phone: Business Phone:
Are you applying for:
Shift choice:
What days and hours are you available for work?
If hired, on what date can you start working?
Are you willing to work Saturdays?
Are you willing to work overtime?
What is your minimum salary requirement?
Do you have any commitments to another employer that might affect your employment with us?
If yes, explain:
If you are under 18 years of age, can you provide required proof of your eligibility to work?
Have you ever worked for Merrill Iron & Steel, Inc. before?
If yes, please state position(s) held, dates worked, and reason for leaving:
Do you have any friends, relatives, or acquaintance working for Merrill Iron & Steel, Inc.?
If yes, state name and relationship:
If hired, would you have dependable transportation to and from work?
Are you a United States citizen?
If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States as required by the U.S. Government?
Are you able to perform the essential functions of the job for which you are applying?
From: mm/yy
To: mm/yy
Name and Address of Employer Salary Position Reason for Leaving
Education Name and location of school Years
Did you
Subject Studied
High School
Trade, Business, or Correspondence School
List name and telephone number of three business/work references that are not related to you. If not applicable, list three school or personal references that are not related to you.
Name Telephone w/Area Code Years Known
Do you require a reasonable accommodation in order to perform the essential functions of the job for which you are applying?
If yes, what is that accommodation?
(Note: Company complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.)
Have you ever been convicted of a criminal offense (felony or misdemeanor)?
If yes, please briefly describe the crime(s):
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
I certify that the information given by me on this application is true and correct and I understand that any misrepresentation or omission of any information will result in my disqualification from consideration for employment or, if employed, my dismissal.
I hereby authorize you to contact references, past or present employers, persons, schools, law enforcement agencies and any other source of information that may be relevant to my application (and accompanying resume, if any) for employment and release all parties from all liability for any damage that may result from furnishing same to you.
I understand that this application is not a contract, offer, or promise of employment and that if hired, I will be able to resign at any time for any reason. Likewise, the Company can terminate my employment at any time with or without cause, unless otherwise required by law. I further understand that no one other than the President of Merrill Iron & Steel, Inc., or Director of Human Resources has the authority to enter into an employment contract or agreement with me, and that my at-will employment can be changed only by a written agreement signed by the President of Merrill Iron & Steel, Inc.
I understand this application will be kept in the active files for a period of 6 months from the date indicated below. I further understand that if I am not hired during that period, I must complete and execute a new application form to be considered for future employment.
Thank you for completing this application. Please click “Submit” to forward this application for consideration.

Your application has been succussfully submitted to
Merrill Iron & Steel, Inc.
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