Hollmann Specialty Co. Application for Employment

Please complete the following application for employment consideration. Click the Submit Button at the end of this form to send us your completed application.

First Name:		Last Name:

Address:		Do you have a Social Security Number? Yes No

		Sex: Male Female


Date of Birth:		E-Mail Address:

Phone Number:		Fax Number:

Our dates of available employment are May 15 - November 10. Please list a starting and end date that you are available to work.

Do you have an International Driver's License? Yes No
If yes, what is the largest vehicle you have driven?
Do you have any trailer pulling experience? Yes No

Do you have any health restrictions that would prevent you from standing for long periods of time, lifting heavy objects, etc? Yes No
If yes, please explain below:

Are you taking any prescription medications? Yes No
If yes, list the medications and what you will need to get them in the USA:

How did you hear of this position?

Why do you want to work for us?

What are your qualifications/ skills?

What are your interests/ hobbies?

What do you hope to gain from this experience?

Your Emergency Contact Information:
Name:
Phone Number:
Relationship:

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