GLASSource LLC Application

Employment Application

NOTE: Completeness of the application is important and typically improves the likelihood of being considered for employment. Some information is required but not all. It is recommended that you supply as much information as possible.
You must be 18 years of age to apply.

* indicates required fields

If you would like to also include a resume, please email it to hr@glassource.net

Interested in working at a different Basco facility? Visit Careers | Basco Shower Doors to view job listings at our other locations!

Personal Information

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Referred By

Employment Desired

Desired Position

Desired Shift

Date you can start

YYYY

Desired Wage/Salary

Currently Employed?

If so, May we contact them?

Have you Applied Here Before?

Education History

Grammar School

Years Attended

Did you Graduate?

High School

Years Attended

Did you Graduate?

College

Years Attended

Did you Graduate?

Subjects Studied

General Information

Subjects of Special Study/Research Work or Special Training/Skills

Military Service

Branch/Rank

Former Employers

Employer 1 (most recent/current)

Employer

Phone

Currently Employed Here?

Employment Start Date

YYYY

Employment End Date

YYYY

Ending/Current Wage/Salary

Ending/Current Position

Reason for Leaving

Reason for Leaving, if Other:

Employer 2

Employer

Phone

Currently Employed Here?

Employment Start Date

YYYY

Employment End Date

YYYY

Ending Wage/Salary

Ending/Current Position

Reason for Leaving

Reason for Leaving, if Other:

Employer 3

Employer

Phone

Currently Employed Here?

Employment Start Date

YYYY

Employment End Date

YYYY

Ending/Current Wage/Salary

Ending/Current Position

Reason for Leaving

Reason for Leaving, if Other:

References

Reference 1

Name

Relation

Business

Years Known

Phone

Reference 2

Name

Relation

Business

Years Known

Phone

Reference 3

Name

Relation

Business

Years Known

Phone

Criminal Background

Have you ever been convicted of a felony?

If yes, Please explain any charges

Additional Comments

Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal, or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws." Digital Signature - By signing (typing your name & today's date below) you agree to statements above

First and Last Name

Today's Date

YYYY

Human Verification

3+2+1=

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