Job Application

Fields marked with an asterisk (*) must be filled out before submitting.

Contact Information

Full Name *
Street Address *
City *
State *
Zip Code *
E-mail
Phone *
Are you 18 years of age or older? * Yes
No
Desired Wage
Upload a Resume
Were you referred by a current employee of Pilkington? Yes
No
If so, name the employee who referred you.
Have you ever worked or applied for a position with Pilkington? Yes
No
What is your requested work schedule? Full Time (Day)
Full Time (Night)
Part Time (Day)
Part Time (Night)
Temporary
Requested Start Date

The following information is optional, but omitting your response may keep you from being eligible for hire:

Qualifications – Work Experience

Current/Last Employer
Phone
Job Title
City
State
Names of Supervisor
Employment Start Date
Employment End Date
Wage at Start
Wage at End
Job Duties
Reason for Leaving
Employer 2
Phone
Job Title
City
State
Name of Supervisor
Employment Start Date
Employment End Date
Wage at Start
Wage at End
Job Duties
Reason for Leaving
Employer 3
Phone
Job Title
City
State
Name of Supervisor
Employment Start Date
Employment End Date
Wage at Start
Wage at End
Job Duties
Reason for Leaving

Qualifications – Education

School/College 1
City
State
Number of Years Attended
Did you graduate? Yes
No
Degree
School/College 2
City
State
Number of Years Attended
Did you graduate? Yes
No
Degree
School/College 3
City
State
Number of Years Attended
Did you graduate? Yes
No
Degree

Qualifications – References

Name of Reference 1
Phone
Nature of Relationship
Name of Reference 2
Phone
Nature of Relationship
Name of Reference 3
Phone
Nature of Relationship
Please list any knowledge, skills and abilities you might bring to this position.
* I have the legal right to work in the United States.
* I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize Pilkington to investigate any and all statements contained in this application for employment as may be necessary in arriving at an employment decision. I have been informed of the company’s participation in E-Verify. I understand that this application is not intended to be a contract of employment. In the event of employment, I understand that false or misleading information given on my application or interview will result in termination. Pilkington is an equal opportunity employer.
 

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