MENU Have Question? Give Us a call: 320-842-3357 Application for Employment if you are interested in a position with Custom Roto Mold please stop in and fill out an application or fill out an online application here.You share the costs of Medical benefits, and Custom Roto Mold Inc. provides other benefits at no cost to you (Life/AD&D, Short-Term Disability and Long-Term Disability). In addition, there are volutary Life/AD&D, Dental and Vision benefits that you can purchase with reasonable group rates through Custom Roto Mold Inc. payroll deductions. Medical Dental Vision Basic Life Short-Term Disability Long-Term Disability Voluntary Term Life WorkLifeMatters (EAP) WillPrep Services APPLICATION FOR EMPLOYMENT Personal First Name: Middle Name: Last Name: Street Address Apartment # City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: Primary Phone: Secondary Phone: Email Address: Emergency Contact Name: Relationship to Contact: Emergency Phone #: We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or handicap, or any other legally protected status. Are you 18 years of age or older? Yes No Have you ever filed an application with us before? Yes No Have you been employed with us before? Yes No Are you legally eligible for employment in the United States? Yes No Are you currently on "lay-off" status and subject to recall? Yes No How did you hear about us? Online Newspaper Career Fair Radio Television Position Applying For: Office Assembly Machine Operator Shipping Maintenance Other Additional Information: Complete only if you are applying for the positions of machine operator, molding, cut/trim, shipping, maintenance or any type of assembly positions--the job descriptions require lifting. The prospective employee must pass a back screen to qualify for these positions. Are you able to perform the essential requirements of the job? Yes No Available to Work: Full Time Part Time Seasonal-Dates: Student-Dates: What shifts can you work? Day Second Night Any On what date would you be available for work? Can you travel if a job requires it? Yes No Person recommending you for position: State any additional information you feel may be helpful to us in considering your application Employment History Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status. List complete employment history, but do not provide dates or employment for jobs held more than five years ago. Employer #1 Employer Name: From: To: Still Employed? Yes Street Address: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: Employer Phone: Email Address: Supervisor Name: Supervisor Contact: Your Title: Pay Rate: Duties: Reason for leaving: May we contact your employer? Yes No Employer #2 Employer #3 Employer #4 Education Elementary School Attended: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: High School Attended: Did you graduate? Yes No Highest Grade Completed: 9 10 11 City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: College #1 College Attended: School Undergraduate Graduate Did you graduate? Yes No Major Minor Degree Certificate Diploma Associate Bachelor Master Doctorate City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: Unofficial Transcripts College #2 Supplementary Information Describe any specialized training, Apprenticeship, skills and extra-curricular activities. Describe any honors you have received. List professional, trade, business or civic activities and offices held. Certification Certification / License Number: Certification Certification / License Number: References: Give name, address and telephone number of three references who are not related to you and are not previous employers. Name #1 Address Phone Number Name #2 Address Phone Number Name #3 Address Phone Number Have you ever had any job-related training in the United States military? Yes No Miscellaneous WE ARE AN EQUAL OPPORTUNITY EMPLOYER Applicant’s Statement I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 6 months. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Have you read over, and agreee with the agreement? Yes Type your Name: Date: For spam control purposes, type the following characters in the box below: 36985 You may attach a resume or cover letter along with your application: LIMITED FILE SIZE: 1MB (1,000KB) CRMTM Custom Roto-Mold is an ISO 9001:2015 certified manufacturer providing custom plastic solutions. Using the latest roto-molding technology, tooling and turn-key services, we create an exceptional customer experience. Barrier Solutions Website: www.floodstopbarrier.com Contact Information 555 22nd Street South Benson, MN 56215-0348 Have questions? Give us a call! Phone: (320) 842-3357 Fax: (320) 842-3060 Email Us Copyright Custom Roto Mold, Inc. 2020 - 2021 All rights reserved. Website Design by: E*Tap Marketing