Employment Application

If you have any questions, please contact our main office for more informtion or email careers@antoncoop.com 

Email Resume to careers@antoncoop.com
Personal Information
Name *
Street Address *
State *
City *
Zip Code *
Home Phone *
Cell Phone
Marital Status - Number of Dependents *
Position Applying For
Title *
Reason for Applying *
Where did you hear about this position?
Date Available *
Highest Level of Education Completed
High School (Name, City, State, Graduation Year) *
College/Trade School (Name, City, State, Graduation Year) *
Other Education *
Work Experience
Current or Last Employer
Employer Name
May we contact them? *
Dates Employed (Month,Year-Month,Year) *
Salary *
Reason for Leaving *
Employer Phone Number
Employer Email Address
Describe Your Job Duties
Other Past Employer
Employer Name
May we contact them?
Dates Employed (Month, Year-Month, Year)
Reason for Leaving
Employer Phone Number
Employer Email Address
Describe Your Job Duties
Other Information
What Benefits Do You Need? *
How Many Hours a Week Can You Work? *
How Would You Rate Your Health * Poor
Do you have any health problems or physical impairments that would prohibit your from doing the job applied for? *
If so, please explain *
How often do you use tobacco? This has no bearing on eligibility but can affect insurances: * Frequently
Do you have any other obligations that would interfere with your work? *
If Yes, Please Explain
Are you presently employed? *
Have you had any job related injuries? *
Do you have any objection to overtime if needed? *
Can you travel if required? *
Can you submit proof of legal employment authorization and identity?
Do you currently have a CDL? *
Are you willing and able to relocate to our general area? *
Have you been convicted of any crime; excluding sealed convictions? *
List any experience and abilities in the following fields: List equipment you have operated: Driving experience: Welding experience: Mechanical experience: Machinery maintenance abilities: Supervisory skills or accomplishments: Computer skills: Skill or ability to interact with fellow employees: Ability or experience interacting with customers: Organizational experience or skills: Any other pertinent information:
Employment References
List two references other than previous employers. Only one may be a family member
First Reference
Phone Number
Email Address
Second Reference
Phone Number
Email Address
We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of excluding any applicant from consideration for employment. Equal access to employment applications is available for all persons. It will be understood that this application does not guarantee a current job opening nor does it obligate Anton Coop to hire me or retain or consider this application for future openings. I authorize the potential employer to contact and verify the information provided in this application from all previous employers and other references listed in this application. I also release from liability the potential employer and its representatives for gathering information to make employment decisions and all others for providing such information. I understand that there is no specified length of employment stated and this application does not constitute a contract for employment. I understand that myself or the employer can terminate the employment at will with or without cause as long as there are no state or federal law violations. I understand that if employed I will be required to provide identity and proof of legal work authorization. Failure to provide this information will result in immediate termination of employment. I understand that if an offer of employment is received it may be conditional upon testing for use of illegal drugs and a background investigation. I certify that the facts contained in this application are true and correct to the best of my knowledge and I understand that, if employed any false or concealed statements made here will be grounds for dismissal, without regard to when such facts are discovered. I have read the statements above and agree to and understand what has been presented.
Electronic Signature *
Date *
* Required field