776-B Old State Route 74
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Employment Application
The Atlantes 776-B Old State Route 74 Cincinnati, Ohio 45245 513-399-6225 513-399-6227 fax Equal Opportunity Employer- The Atlantes is committed to providing equal employment opportunity to all applicants and employees in accordance with all applicable equal opportunity and affirmative action laws, directive and regulation of Federal, State and Local governing bodies and agencies.. In keeping with this commitment, The Atlantes will recruit, hire train and promote into all job levels the most qualified individuals without regard to race, color, creed, religion, sex, national origin, ancestry, marital status, disability and, sexual orientation or, military status.
Applicant Information
Full Name: Date: Last First M.I.
Address: Street Address Apartment/Unit #
City State ZIP Code
Phone: Email
Date Available: Social Security No.: Desired Salary:$
Position Applied for: ______Hours/Days NOT available______
YES NO YES NO Are you a citizen of the United States? If no, are you authorized to work in the U.S.?
YES NO Have you ever worked for this company? If yes, when?
YES NO Have you ever been convicted of a felony? If under the age of 18, do you have a work permit Yes No
If yes to Felony, explain:
Education
High School: Address:
YES NO From: To: Did you graduate? Diploma::
College: Address:
YES NO From: To: Did you graduate? Degree:
Other: Address:
YES NO From: To: Did you graduate? Degree: Employment Application References
Please list three professional references.
Full Name: Relationship: Company: Phone: Address:
Full Name: Relationship: Company: Phone: Address:
Full Name: Relationship: Company: Phone: Address:
Previous Employment
Company: Phone: Address: Supervisor:
Job Title: Starting Salary:$ Ending Salary:$
Responsibilities:
From: To: Reason for Leaving:
YES NO May we contact your previous supervisor for a reference?
Company: Phone: Address: Supervisor:
Job Title: Starting Salary:$ Ending Salary:$
Responsibilities:
From: To: Reason for Leaving:
YES NO May we contact your previous supervisor for a reference?
Company: Phone: Address: Supervisor:
Job Title: Starting Salary:$ Ending Salary:$ Employment Application Responsibilities:
From: To: Reason for Leaving:
YES NO May we contact your previous supervisor for a reference?
Military Service
Branch: From: To:
Rank at Discharge: Type of Discharge:
If other than honorable, explain:
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature: Date:
______Do not write below this line: Office only
Interviewed by:______Date:______Hired: ___Yes _____No
Remarks:______
______
Neatness:______Ability:______position:______
Wage:______Hours______Employment Application