Job Application

Fields marked with an asterisk (*) must be filled out before submitting.

Personal Details

First Name *
Last Name *
Email Address *

Personal Information

Address *
City *
Country *
Telephone *
Cell phone
Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.) * Yes
If hired, can you present evidence of your legal right to work in this country? * Yes
Are you available to work: * Full-Time
Temporary or Seasonal
Are you available to work: * Day Shift
Second Shift
Have you applied to QCMI before? If yes, please give date. If no, please leave blank.
Do you have any friends or relatives working at QCMI? If yes, please list names. If no, please leave blank.
Have you been employed at QCMI before? If yes, please give last termination date.
If hired, what date can you start work? *
Desired Salary? *
Are you currently employed? * Yes
May we contact your employer? * Yes


Do you have a degree? * Yes
Where did you complete your degree? If none, please type N/A. *
Number of Years Completed *
Title of your degree? *
Do you have any other experience, training, qualifications, or skills which you feel make you especially suited for the role at QCMI? If so, please explain. If not, please leave blank.
Have you obtained any special skills or abilities as a result of service in the military? If so, please describe. If not, please leave blank.
Are you able to perform the essential functions of the job for which you are applying for, either with or without reasonable accomodation? If no, please describe functions that cannot be performed. If you are fully able, please leave blank.
Upload your Resume/CV

Employment History

1. Name of Employer *
1. Telephone Number *
1. Type of Business *
1. Name of Supervisor *
1. Address *
1. City *
1. State *
1. Zip Code *
1. Start Date of Employment *
1. Termination Date of Employment *
1. Position & Duties *
1. May we contact this employer for a reference? * Yes
1. Reason for Leaving *
2. Type of Business
2. Name of Employer
2. Telephone Number
2. Address
2. Name of Your Supervisor
2. City
2. State
2. Zip Code
2. Start Date of Employment
2. Termination Date of Employment
2. Position & Duties
2. May we contact this employer for a reference? Yes
2. Reason for Leaving
3. Name of Employer
3. Telephone Number
3. Type of Business
3. Name of Supervisor
3. Address
3. City
3. State
3. Zip Code
3. Start Date of Employment
3. Termination Date of Employment
3. Position & Duties
3. May we contact this employer for a reference? Yes
3. Reason for Leaving


1. First and Last Name *
1. Telephone Number *
1. Occupation *
1. No. of Years Acquainted *
2. First and Last Name *
2. Telephone Number *
2. Occupation *
2. No. of Years Acquainted *
3. First and Last Name *
3. Telephone Number *
3. Occupation *
3. No. of Years Acquainted *

Please Read Carefully – Initial Each Paragraph and Electronically Sign Below

I hereby certify that I have not knowingly withheld any information that may adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatements of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *
I hereby authorize Quality Controlled Manufacturing, Inc. to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. *
I understand that offers of employment are conditioned upon successful completion of a drug and alcohol test. *
I understand that if I provide false or misleading statements during the interview or on the application, I will not be considered for employment. If such statements are discovered after employment commences, the employee’s employment may be terminated. *
I understand that nothing contained in this Employment Application or in the granting of an interview, and no Company policies, procedures, or handbooks that I might receive, are intended to create an employment contract between the Company and myself: (1) for a specific length of time or under which I can only be terminated for good cause; or (2) limiting the Company’s right to transfer, demote, suspend or administer employee discipline. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the Company unless made in writing by the President of the Company. *
If an employment relationship is established, I understand that the Company and I both have the right to terminate my employment at any time for any reason or no reason, and that the Company retains the absolute right to transfer, demote, and administer employee discipline at any time for any reason. This pre-employment statement contains the entire agreement between me and the Company regarding the subjects discussed herein. It supersedes any and all other agreements, either oral or in writing, between me and the Company regarding the subjects discussed herein. I acknowledge that no representations, inducements, promises or agreements, oral or otherwise, regarding the subjects discussed herein, have been made to me which are not embodied herein, and acknowledge that no other agreement, statement or promise not contained in this pre-employment statement may not be modified by oral agreement or course of conduct, but only by an agreement in writing signed by the President of the Company and me. *

EEO Data Sheet

Please copy and paste the link below into the new tab and upload the completed form to the section below.
Please upload the completed form in the adjacent file upload location.
Signature * I certify that all information provided on this application is correct.
Date *
* I have read and understood the privacy policy (see below in footer). Open in new tab if needed.

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