Please provide the following information:

Personal Information
First Name
Middle Initial
Last Name
Mailing Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone
E-mail
Employment Desired (required)
Position
Shift
Salary desired
Are you Employed?	Yes Or No
Have you ever applied to EPTAM Plastics before?	Yes Or No
If so, When?
Have you ever been employed here?	Yes Or No
If so, When?
No employers listed below will be contacted until such time that an interview and an Employment Application has been completed and signed by you.
Work History Please list date of employment, employer address, position held/duties, and reason for leaving.
Special Skills  or Training Certifications, etc.