Printwell Acquisition Co., Inc. is an equal opportunity employer and does not discriminate against applicants or employees on the basis of sex, race, color, religion, national origin, ancestry or age. In addition Printwell Acquisition Co., Inc. does not discriminate against qualified individuals with disabilities.
PERSONAL INFORMATION
Position(s) Applied For: 
 Date of Application:
09/05/2010
Last Name: 
 First Name: 
 Middle Name:
Address: 
 City: 
 State: 
 ZIP: 
Home Phone: 
 Work Phone:
SSN: 
 Over 18 year old?: 
Date Available for Work:
 Type of Employment: 
Are you eligable for employment in this country? 
 Have you applied to work with us before? 
Have you ever been convicted of a violation of the law other than a minor traffic violation? 
 If yes, please explain:
EMPLOYMENT HISTORY
From:
 To:
 Employer:
 Telephone:
Job Title:
 Address:
Immediate Supervisor:
 Summary of Work Performed and Job Responsibilities:
Reason for Leaving:
Hourly Rate/Salary:
Start $:
 Per:
 Final $:
 Per:
JOBS YOU'VE ADDED
If hired, proof of your employment eligibility in the United States must be established by appropriate document at the time you begin work at Printwell Acquisition Co., Inc. Will you be able to provide the appropriate documents? 
Are you willing to work an irregular schedule, overtime, on different shifts, and on weekends when necessary? 
Do you have access to adequate transportation to travel to and from work? 
SKILLS & QUALIFICATIONS
Summarize special skills & qualifications acquired from employment or other experiences that may qualify your for work here. 
EDUCATIONAL BACKGROUND
  Name & Location Years Completed Did you Graduate? Course of Study/Degrees Received
SCHOOLS YOU'VE ADDED
U.S. MILITARY SERVICE
Branch:
 Dates of Service:
From:
To:
Highest Rank Achieved:
 Duties:
REFERENCES
Name Telephone Years Known
     
     
     
OPTIONAL: INCLUDE A RESUME

CERTIFICATION AND AUTHORIZATION Please Read Carefully
I certify that all facts contained in the application are true and complete and acknowledge that Printwell Acquisition Co, Inc. is relying on the accuracy of the information provided. I authorize Printwell Acquisition Co., Inc. to verify the accuracy of the information provided herein, and I authorize former employers, educational institutions and credit agencies to release information concerning me to Printwell Acquisitions Co., Inc.. I also authorize Printwell Acquisition Co., Inc. to give references and provide information about me in response to inquiries subsequent to my employment if hired. I understand that falsification, misrepresentation or omission of requested facts may result in denial of employment, or if employed, may result in immediate dismissal. I understand and agree that, if hired, my employment will be for no definite period and may, regardless of the date of payment of wages, be terminated at any time without previous notice and with or without reason, at the will of either myself or Printwell Acquisition Co., Inc.
Electronically Sign By Typing Full Name Below 
SUBMIT APPLICATION
26975 Northline Rd., Taylor, MI 48180 • TOLL FREE: (866) 822-0101
Copyright ® 2009 Printwell Printing, Inc.