Employment Application

Please Note: This form is only for Employment Applications.

    Are you eligible to work in the United States? YesNo

    Are you at least 18 years old or older? (If no, you may be required to provide authorization to work) YesNo

    Have you ever been terminated from employment or asked to resign by an employer? YesNo
    If yes, please provide company names and details

    Have you ever worked for InChem before? YesNo
    If yes, please provide details

    Do you know anyone who currently works for our company? YesNo
    If yes, who?

    Position applying for

    Hourly Rate/Salary Desired

    Are you currently employed? YesNo
    If yes, may we inquire of your present employer?

    Can you work any shift? YesNo
    If no, explain

    Can you work overtime, including weekends? YesNo
    If no, explain

    Date you can start work

    Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation? YesNo

    Have you been convicted of an unlawful offense other than a minor traffic violation within the last 7 years? Conviction will not necessarily disqualify an applicant from employment. YesNo
    If yes, explain

    How did you hear about us? Walk In, Ads, Referral by Who?, Other

    Education: Name & Location of School, #Yrs Completed, Diploma/Degree Received, Course of Study

    EMPLOYMENT EXPERIENCE: Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

    1.
    Employer
    Address
    Telephone Number
    Job Title
    Immediate Supervisor
    Reason for Leaving
    Dates Employed (from, to)
    Hourly Rate/Salary (starting, final)
    Work Performed

    2.
    Employer
    Address
    Telephone Number
    Job Title
    Immediate Supervisor
    Reason for Leaving
    Dates Employed (from, to)
    Hourly Rate/Salary (starting, final)
    Work Performed

    3.
    Employer
    Address
    Telephone Number
    Job Title
    Immediate Supervisor
    Reason for Leaving
    Dates Employed (from, to)
    Hourly Rate/Salary (starting, final)
    Work Performed

    4.
    Employer
    Address
    Telephone Number
    Job Title
    Immediate Supervisor
    Reason for Leaving
    Dates Employed (from, to)
    Hourly Rate/Salary (starting, final)
    Work Performed

    Additional Information

    List professional, trade, business or civic activities and offices held.
    You may exclude membership which would reveal gender, race, national origin, age, ancestry, disability or other protected status.

    Summarize special job-related skills and qualifications acquired from employment or other experience.

    State any additional information you feel may be helpful to us in considering your application.

    REFERENCES (Give the names of three persons not related to you, whom you have known at least three years.)

    1.
    Name
    Address, Phone, Email
    Company
    Years Acquainted

    2.
    Name
    Address, Phone, Email
    Company
    Years Acquainted

    3.
    Name
    Address, Phone, Email
    Company
    Years Acquainted

    Pleas Upload Resume:

    Please read carefully before submitting.
    InChem Rock Hill LLC is an equal opportunity employer. InChem Rock Hill LLC does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

    I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for InChem Rock Hill LLC to hire me. If I am hired, I understand that either InChem Rock Hill LLC or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of InChem Rock Hill LLC has the authority to make any assurance to the contrary.

    I attest with my submission below that I have given to InChem Rock Hill LLC true and complete information on this application. No requested information has been concealed. I authorize InChem Rock Hill LLC to contact references provide for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.


    InChem Holdings Inc.
    800 Celriver Rd.
    Rock Hill, SC 29730
    800-331-7721
    For map and directions to InChem click here.

    Interested In A Career At InChem?

    Contact Robin Bramblett
    InChem Human Services
    1-800-331-7721
    Email rbramblett@inchemcorp.com