Join the Tri-Bolt Team
If you do not have a middle name, just use a dash -
                           
APPLICANT INFORMATION
Last Name: First: M.I.: DOB:   
Street Address: Apartment/Unit #:
City: State: Zip:
Phone: -- Email Address:
Available:    Social Security No. --
Position Applied for:
Are you a citizen of the United States?
Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
Yes
No
If so, when?
Have you ever been convicted of a felony?
Yes
No
If yes, explain below
                     
EDUCATION
High School Address
From To Did you graduate?
Yes
No
Degree
College Address
From To Did you graduate?
Yes
No
Degree
Other Address
From To Did you graduate?
Yes
No
Degree
 
   
REFERENCES
Please list three professional references.
Full Name Relationship
Company Phone --
Address
 
Full Name Relationship
Company Phone --
Address
 
Full Name Relationship
Company Phone --
Address
           
PREVIOUS EMPLOYMENT
Company Phone --
Address Supervisor
Job Title Starting Salary $ Ending Salary $
Responsibilities
From To Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
   
 
Company Phone --
Address Supervisor
Job Title Starting Salary $ Ending Salary $
Responsibilities
From To Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
   
 
Company Phone --
Address Supervisor
Job Title Starting Salary $ Ending Salary $
Responsibilities
From To Reason for Leaving
May we contact your previous supervisor for a reference?
Yes
No
   
 
     
MILITARY SERVICE
Branch From To
MOS Type of Discharge
If other than honorable, explain
   
DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.

I give permission to Tri-Bolt LLC or Agency on their behalf, to conduct a background investigation in accordance with all Federal and State Laws.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Electronic Signature

To electronically sign this application, enter any alpha/numeric characters (letters/numbers) of your choosing, preceded and followed by the forward slash (/) symbol. Most signatories enter their name between the two forward slashes.

Examples of acceptable "signatures" include:

/john doe/
/jd/
/123-4567/
/Betsy R. Ross/
/O'Malley McGee, D.D.S./
Signature Date

Tri-Bolt is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.