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Please call us at 812-753-3029if you have any issues with the job application form.

    Personal Information

    First Name*

    Last Name*

    Address*

    City*

    State*

    Zip Code*

    Home Phone*

    Email Address*

    Social Security Number*

    Additional Information

    Date Available

    What position would you like to apply for?
    TechnicianOffice Administration

    Desired Salary

    Are you eligible to work in the United States?
    YesNo

    Have you ever worked for this company?
    YesNo

    If yes, when?

    Have you been convicted of a felony or misdemeanor that has not been expunged by a court?
    YesNo

    If yes, please explain

    Education

    High School Education

    Select the highest grade completed
    9101112

    School Name

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    College Education

    Did you graduate?
    yesno

    School Name

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    Degree Received

    Other Education

    Did you graduate?
    yesno

    School Name

    City

    State

    Degree Received

    Military Service

    Military Experience

    Branch

    Dates Served

    Rank at discharge

    Type of discharge

    If other than honorable, please explain

    Can you provide a copy of your DD214?
    YesNo

    Employment History

    Employer #1

    Company Name

    City

    State

    Phone

    Supervisor

    Job Title

    Wage or Salary

    Job Responsibilities

    Dates of Employment

    Reason for Leaving

    May we contact your previous employer for a reference?
    YesNo

    Employer #2

    Company Name

    City

    State

    Phone

    Supervisor

    Job Title

    Wage or Salary

    Job Responsibilities

    Dates of Employment

    Reason for Leaving

    May we contact your previous employer for a reference?
    YesNo

    Employer #3

    Company Name

    City

    State

    Phone

    Supervisor

    Job Title

    Wage or Salary

    Job Responsibilities

    Dates of Employment

    Reason for Leaving

    May we contact your previous employer for a reference?
    YesNo

    Credentials, Licenses, Special Skills, Abilities, Affiliations

    Tell us about any special job related skills and qualifications acquired from employment or other experience that you think are important. Also use this space to tell us about your personal interests and other information you believe will assist us in evaluating your qualifications.

    We're 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.

    Disclaimer & Agreement

    I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date.

    I authorize Prodigy Mold & Tool, Inc. to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment.

    If requested, I agree to submit to a criminal background investigation, motor-vehicle report, credit check, and drug/alcohol screening for illegal substances upon conditional offer of employment.

    I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment.

    I understand that employees of Prodigy Mold & Tool, Inc. serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law.

    If employed, I will be required to furnish proof of eligibility to work in the United States, and I will be required to comply with company policies and procedures.

    By clicking submit below, you agree to the disclaimer above. Please read carefully.

    Prodigy Mold & Tool, Inc.

    88 E. 1100 S.
    Haubstadt, IN 47639

    812-753-3029
    Ext 115

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