Webb Wheel | Brakedrums

OEM Truck Application

IMPORTANT:

Fill out all information below accurately and click the "Submit Employment Application" button below.

Note: if you are unable to submit and the field is yellow enter NA if it is not applicable.

EXPERIENCE
List all present and past employment for the last ten years beginning with your most recent.
Current/Past Employer 1 (Most Recent)
Employer:
Start Date:
Final Date:
Address:
Job Title:
Starting Hourly Rate/Salary:
Final Hourly Rate/Salary:
Supervisor:
Reason For Leaving:

AFTERMARKET
Toll Free: ‍800-633-3256 • Fax: ‍256-739-6246 • Email: sales@webbwheel.com

OES AFTERMARKET
Toll Free:‍888-857-9677 • Sales Email: oessales@webbwheel.com

OEM TRAILER
Toll Free: ‍866-824-8753 • Sales Fax: ‍812-548-0970
General Mailbox: oemsales@webbwheel.com

OEM SPECIALTY TRUCK
Phone: ‍812-548-5460 • Main Fax: ‍812-548-5493
General Mailbox: oemsales@webbwheel.com

PERSONAL INFORMATION
Preferred Work Location:	Tell City, IN Ferdinand, IN Both
First Name:
Middle Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip:

Home Phone:
Cell Phone:
Business Phone:
	Check which phone you preferred to be contacted. Home Phone Cell Phone Business Phone
Email:

POSITION
Position you are applying for:
Date available:
Type of position you are seeking:	Full Time Part Time
How did you hear about this position?	Newspaper Friend/Word of Mouth Internet Employment Agency Employee referral School/College Other
Have you ever applied for a position with us?	Yes No
If yes, when did you apply?
Have you ever worked for Webb Wheel before?	Yes No
If yes, position held?
If yes, when did you work?

Are you currently employed?	Yes No
Names of relatives employed here now or in the past:

EDUCATION
School 1
Name of School:
Type of School:	High School Technical College Other
School Location:
School Address 1:
School Address 2:
School City:
School State:
School Zip:
Number of years completed:
Received Degree?	Yes No
Major:
Describe any specialized training, skills, and extra-curricular activities:

EDUCATION
School 2
Name of School:
Type of School:	High School Technical College Other
School Location:
School Address 1:
School Address 2:
School City:
School State:
School Zip:
Number of years completed:
Received Degree?	Yes No
Major:
Describe any specialized training, skills, and extra-curricular activities:

Eligibility
Are you over 18 years of age?	Yes No
May we contact your present or previous employers?	Yes No
If no, tell us why:

In order to permit a check of your work and education records, should we be made aware of any change of name or assumed name that you previously used?	Yes No
If yes, verify names and dates:
Have you ever been discharged or involuntarily forced to resign from any employment?	Yes No
If yes, explain:
Are you eligible for rehire from previous employers?
Except for vacations and holidays, how many work days were you absent during the past calendar year?
Except for vacations and holidays, how many work days were you absent during the previous year?
Comments on absences?
If you are applying for a position involving evening or weekend work, can you fulfill such scheduling requirements?	Yes No
Are you willing to work overtime as requested?	Yes No
If employment is offered, can you submit a birth certificate, social security card, and certificate of U.S. citizenship or verification of your legal right to work in the U.S.	Yes No
If employment is offered, can you produce personal identification such as US passport, driver’s license, or photo I.D. issued by the State?	Yes No
Proof will be required upon hire.

Have you ever been convicted of a felony?	Yes No
If yes, describe in full. A conviction is not an automatic bar to employment. Facts and circumstances will be considered.