608-847-6667
1025 Parker Drive
Mauston, Wisconsin 53948
608-462-8293
405 Elroy Street
Elroy, Wisconsin 53929
Current Job Openings:
      Brunner Manufacturing in Mauston
      CNC Machine Operator/Setup Programmer
      Tool & Die Maker

First Name *

Middle Name *

Last Name *


Address *
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Email *

Primary Phone Number * (000-000-0000)

Secondary Phone Number (000-000-0000)


Position(s) Applying For *


If necessary, the best time to call you is *


May we contact you at work? *

If Yes, th best time to call is


Work Phone Number (000-000-0000)


Have you ever been employed here before? *

If Yes, Give dates (mm/yyyy)
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What is your desired salary range or hourly rate of pay? *


Type of employment desired *




Will you relocate if the job required it? *

Will you travel if the job requires it? *

If they have been explained to you, are you able to meet the attendance requirements of the position? *


Are you able to preform the essential function of the job for which you are applying? *




EMPLOYMENT HISTORY: Starting with your most recent employer, please provide all of the following information.

Employer 1


Address
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City State
Zip Country

Phone Number (000-000-0000)


Starting job title / Final job title


Immediate Supervisor and title(for most recent position held)


Why did you leave?


Summarize the type of work preformed and job responsibilities.


What did you like most about your position?


What were the things you liked least about your position?


Dates employed (mm/yyyy)
 to

Compensation (starting)


Commission/Bonus/Other Compensation


Compensation (final)


Commission/Bonus/Other Compensation


May we contact for reference?

Reference Email


EMPLOYMENT HISTORY: Employer 2


Address
Line 1
Line 2
City State
Zip Country

Phone Number (000-000-0000)


Starting job title / Final job title


Immediate Supervisor and title(for most recent position held)


Why did you leave?


Summarize the type of work preformed and job responsibilities.


What did you like most about your position?


What were the things you liked least about your position?


Dates employed (mm/yyyy)
 to

Compensation (starting)


Commission/Bonus/Other Compensation


Compensation (final)


Commission/Bonus/Other Compensation


May we contact for reference?

Reference Email


EMPLOYMENT HISTORY: Employer 3


Address
Line 1
Line 2
City State
Zip Country

Phone Number (000-000-0000)


Starting job title / Final job title


Immediate Supervisor and title(for most recent position held)


Why did you leave?


Summarize the type of work preformed and job responsibilities.


What did you like most about your position?


What were the things you liked least about your position?


Dates employed (mm/yyyy)
 to

Compensation (starting)


Commission/Bonus/Other Compensation


Compensation (final)


Commission/Bonus/Other Compensation


May we contact for reference?

Reference Email


Have you ever been fired or asked to resign from a job?

If yes, please explain


Summarize any special training, skills, licenses, and/or certificates that may asist you in preforming the position for witch you are applying *

Choose Any




If you checked any boxes above please provide years of experience for each.


EDUCATIONAL BACKGROUND: Starting with your most recent school attended, provide the following information

School (including city and state)


Years completed

Completed *




If you checked Degree, Certification, and/or Other above, please provide what was completed


GPA: Class Rank

Major/Minor


EDUCATIONAL BACKGROUND: School 2 (including city and state)


Years completed

Completed *




If you checked Degree, Certification, and/or Other above, please provide what was completed


GPA: Class Rank

Major/Minor


List special accomplishments, publications, awards, etc. *


Any job-related information you want us to know about you? *


Upload Resume (100MB Max.)


APPLICANT STATEMENT: I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct. I expressly authorize, without reservation, the employer, its representatives, employees, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering, and using truthful and non-defamatory informations, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, or federal law. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause, and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause, and with or without prior notice, except as may be required by law. This applicaiton does not constitue an agreement or contract for employemnt for any specified period or definate duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's presidnet. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard. This Company does not tolerate unlawful discrimination in its emploument practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state, or local law. This Company likewise does not tolerate harassment based on sex, race, color, religion, natinal origin, citizenship, age, disability, or any other protected status. Examples of prohibited harassment include, but are not limited to, unwelcome physical contact, offensive gestures, unwelcome comments, jokes, epithets, threats, insults, name-calling, negative stereotyping, possession or display of derogatory pictures or other graphic materials, and any other words or conduct that demean, stigmatize, intimidate, or single out a person because of his/her membership in a protected category. Harassment of our employees is strictly prohibited whether it is committed by a manager, coworker, subordinate, or non-employee (such as a vendor or customer). The Company takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (1) eliminate me from further consideration for employment, or (2) may result in my immediate discharge from the employer's service, whenever it is discovered. You will be required to enter a digital signature which will be binding as your actual signature. Your electronic signature below indicated your agreement with the above statements.

By typing my name in the following box I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement. *


Date: (mm/dd/yyyy)



 

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