Header
/contentonly.aspx?file=images/ls_onlineCat.png does not exist
Abrasives
Adhesives / Sealants / Epoxy
Cable Ties, Hook & Loop, & Accessories
Electronic Hardware
Fasteners Inch and Metric
PEM® Clinch Fasteners
Rivets
Safety Products & PPE
Southco
Adjustable Handles, Knobs, Plungers, Latches
Anti-Static
Batteries & Accessories
Bumpons & Bumpers
Caps, Hole Plugs & Strain Relief
Card Guides & Ejectors
Casters, Levers, & Feet
Cutting Tools & Metal Working
EAS Latches, Hinges, Handles & 1/4-Turn
Electronic Access Solutions
Fans, Fan Guards, & Accessories
Ferrites & EMI Suppression
Fittings
Grommets & Bushings
Handles
Heat Dissipation & Insulators
Heat Shrink Tubing & Wire Markers
Hinges
Hoses & Clamps
I.C. Sockets & Accessories
Inserts
Labels and Printers
Latches, Access Hardware, & 1/4 Turn
LED Hardware
Masking Products
Military Hardware
Nylon Fasteners
O-Rings
PC Board Hardware
Pins
Power Cords & Receptacles
Press
Retaining Rings
Slides, Ball Bearing, & Guides
Spacers and Standoffs
Spray, Solvents, & Paint
Springs
Strain Relief Bushings, Hole Plugs, Cordgrips
Tape
Terminals & Accessories
Tools & Accessories
Vibration Controls
Weld Fasteners
Well & Jack Nuts
Wire, Cable, & Fiber Management

Assembly Fasteners

Employment/Job Application

Required fields are marked with an asterisk (*)

APPLICANT'S STATEMENT:

I understand that the Company is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring promotion, transfer, and compensation to all qualified applicants and employees without regard to age, race, color, national origin, sex, religion, handicap or disability, citizenship status, service member status, or any other category protected by federal, state, or local law.

I authorize former and present employers, and professional, work, and personal references listed in the application and any other individuals I may name, to give the Company or its designee any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release such parties from all liability for any damages that may result from furnishing same to the Company. I also authorize the Company to provide truthful information concerning my employment with it to future employers, and I agree to hold it harmless for providing such information.

I understand that the Company reserves the right, to the extent permitted by law, to require drug and alcohol screening tests of an applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such tests. I consent to the release of the results of any such tests to the Company or its designee. I release the Company and its designee from any and all liability and damages that may result or arise from any drug test or the provision of information in connection with such a test.

I understand that this employment application and any other Company documents are not promises of employment. Should I be employed, I understand that my employment will be on a trial period for three months from the date of my hiring and that I will remain an at-will employee thereafter. I further understand that, if I am employed, I can terminate my employment at any time with or without cause and with or without advance notice and that the Company has a similar right. I understand that no manager, representative, or agent of the Company has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, except that the General Manager may do so in writing.

In return for the Company's agreement to arbitrate legal disputes and for considering this application, I agree by signing below that any dispute of a legal nature arising under federal, state, or local law between me and the Company (including any such claim regarding discrimination, harassment, or any other legal dispute relating to my employment arising under any labor, employment, or civil rights law) will be subject to final and binding arbitration in accordance with the Company's arbitration procedures. I understand that the arbitrator, who will serve as judge and jury, has the same authority to award money damages and other relief, as does a court or jury. If employed, and if required, I agree to sign a stand-alone arbitration agreement that would supplement this one. The Company's arbitration procedures are available for my review on request.

I certify that the information given by me on this application and during the interview process is true and complete in all respects, and I agree that if the information is found to be false, misleading, or unsatisfactory in any respect (in the Company's judgment) that I will be disqualified from consideration for employment or subject to immediate dismissal if discovered after I am hired.

Personal Information

First Name: *
Last Name: *
Address: *
State: *
City: *
Zip Code: *
E-Mail: *
Phone: *
Social Security Number (SSN):
Date Available:
Desired Pay:
Location Applied For: *
Position Applied For:
Employment Desired:

Employment Eligibility

Are you a U.S. Citizen?
Have you ever worked for this employer?
Have you ever pled guilty or no contest to, or been convicted or misdemeanor or felony?
Have you been arrested for any matters for which you are out on bail or on your own reconizance pending trial?
Have you ever been terminated or asked to resign from any job?
Please explain fully explain any gaps in your employment history
May we contact your current employer?
Please indicate any acutal experience, special training and qulaifications that you have which you feel are relevant to the position for which you are applying:
Have you ever used another another name?
Is any additional information relative to change of name, use of an assumed name, or nickname necessary to enable a check on your work/educational record?
If hired, can you furnish proof that you are over 18 years of age?
Are you capable of satisfactorily performing the essential job duties required of the position which you are applying?
Do you have adequate transportation to and from work?

Education

High School

School
City
State
From
To
Graduate?
Years Completed
Degree

College

School
City
State
From
To
Graduate?
Years Completed
Degree

Trade or Correspondence

School
City
State
From
To
Degree

Other

School
City
State
From
To
Degree/Diaploma

Employment History

Employer #1

Company
Email
Phone
Address
City
State
Zip
Starting Pay (Hourly or Salary)
Ending Pay (Hourly or Salary)
Supervisor
Job Title
Responsibilities
Start Date
End Date
Reason For Leaving

Employer #2

Company
Email
Phone
Address
City
State
Zip
Starting Pay (Hourly or Salary)
Ending Pay (Hourly or Salary)
Supervisor
Job Title
Responsibilities
Start Date
End Date
Reason For Leaving

Employer #3

Company
Email
Phone
Address
City
State
Zip
Starting Pay (Hourly or Salary)
Ending Pay (Hourly or Salary)
Supervisor
Job Title
Responsibilities
Start Date
End Date
Reason For Leaving

Employer #4

Company
Email
Phone
Address
City
State
Zip
Starting Pay (Hourly or Salary)
Ending Pay (Hourly or Salary)
Supervisor
Job Title
Responsibilities
Start Date
End Date
Reason For Leaving

References

Reference #1

Name
Relationship
Company
Title
E-Mail
Phone

Reference #2

Name
Relationship
Company
Title
E-Mail
Phone

Reference #3

Name
Relationship
Company
Title
E-Mail
Phone

Military Service

Are you a veteran?
Branch
Rank at Discharge
Starting Date
Ending Date
Type of Discharge
If not honorable, please explain:

This application will be considered "active" for a maximum of thirty (30) days. If you wish to be considered for employment after that time, you must reapply.


Signature

Signature *
Date *
Print Name *
Please enter the characters shown above: