Name *

First Name

Last Name

Date

MM

DD

YYYY

Phone

(###)

###

####

Have you worked at Midwest Control Products previously?

Yes

No

Our work week is Monday through Thursday.

Does that work for you?

Yes

No

Do you have reliable transportation to get to work?

Yes

No

We start at 5:00 AM. Can you make it here ready to work on time?

Yes

No

It will take some getting used to

Some of the work we do can be physically demanding.

Check off all of the following that you are comfortable doing.

Working on my feet all day.

Lifting up to 50 pounds safely.

Driving a forklift.

Working in warmer temperatures.

Are you comfortable with math and measurement?

Check off all that apply to you.

I can read a tape measure.

I can read and use a caliper.

I can read and use a micrometer.

I feel comfortable using an iPad.

If I do not know one of the above, I feel comfortable learning.