Apply For A Job at Piltz Glass and Mirror Company

Piltz Glass and Mirror Company is an equal opportunity employer.

We have staff that perform the following roles:

Office Assistant
Assembler
Glass Cutter
Shipping / Receiving
Installer

If you are interested Apply online to work at Piltz Glass & Mirror Company. Use the form below to apply.

Last Name (required)

First Name (required)

Middle Initial (required)

Address (required)

City (required)

State (required)

Zip (required)

Phone (required)

How Long at this Address? (years) (required)

Highest year of Elementary School Completed (required)

Highest year of High School Completed (required)

High School Graduate?

Highest year of College Completed (required)

Highest year of Graduate School Completed (required)

Major:

Degree Obtained

technical or trade school degrees:

Years Completed:

degrees:

Years Completed:

Apprenticeship programs:

Length (years) of Program:

Completed:

Apprenticeship program 2:

Length (years) of Program:

Completed:

List other applicable education and/or experience:

MILITARY HISTORY
Were you ever a member of the U.S. Armed Services?

DRIVING RECORD

Do you currently hold a valid driver's license?

During the last 3 years of you received a citation for any of the following violation(s):
DWI

Open Bottle

Careless or Reckless Driving

Hit and Run

LEGAL (you are not required nor will you be asked to report whether you have a sealed conviction or arrest.)
Are you a U.S. Citizen?

If No, do you have a legal right & necessary documents to work in the US? (Identity and employment of all new hires will be verified as required by the Immigration and Reform and Control Act of 1986.)

Were you ever discharged by any company

If Yes, give name of company(ies)

Reason for Discharge

Have you ever been convicted of a crime other than a minor traffic violation:

If Yes, please explain:

EMPLOYMENT HISTORY

Employer 1 Name:

Type of Business:

Employer 1 Address:

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Employed From:

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Type of Business:

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Position:

Employed From:

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Employer 3 Name:

Type of Business:

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Employed From:

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Employer 4 Name:

Type of Business:

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Employed From:

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Employer 5 Name:

Type of Business:

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Employer 6 Name:

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Supervisor:

PLEASE READ CAREFULLY
In submitting this application for employment I understand that investigation may be made whereby information is obtained regarding my character, previous employment, general reputation, educational background, and/or criminal history. I authorize anyone possessing information to furnish it to Piltz Glass & Mirror and/or a 3rd party company upon request and I release anyone so authorized. Piltz Glass & Mirror and any 3rd party company from all liability and damages whatsoever in furnishing, obtaining or using this information.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand also, that I am required to abide by all rules and regulations of Piltz Glass & Mirror, In.

I understand and agree that if employed the employment will be at will. That is either I or Piltz Glass & Mirror Company may end the employment relationship at any time for any reason or for no reason. I understand that recipients of this application by Piltz Glass & Mirror does not imply employment and this application and/or any other Piltz Glass & Mirror Company's documents are not contracts of employment.
Date:

Signature of Applicant:

Attach Resume: (optional)

Attach Cover Letter