Application for Employment s50

Application for Employment

Please do not make references to your Resume in lieu of filling in the fields on this application.

PERSONAL INFORMATION Name (Last, First, Middle Initial): Date:

Present Address (Use P.O. Box if mail not deliverable to street address):

Phone Number: Alternate Phone Number:

Email Address:

State the name and relationship to any relative in our employ: Referred by:

EMPLOYMENT DESIRED Position:

Date you can start: Salary Desired:

Are you currently employed? May we contact your current employer?

Have you ever applied to this company When? before? Do you have reliable transportation to Have you ever been convicted of a felony? work? Do you have any physical condition which might affect your work performance? If yes, please explain.

EDUCATION Year Graduated School Name & Location Major Subjects GPA Graduated Yes No Grammar School High School College/ University Other (Specify)

Please complete reverse side. OTHER INFORMATION List any special training or experience that might relate to this position:

FORMER EMPLOYERS Start with present or most recent.

Date Name, Address & Phone Number of Salary Position Reason for MM/YYYY Employers Leaving From:

To: Per:

REFERENCES Please list three persons not related to you, whom you have known at least one year.

Name Address & Phone Number Business Years Acquainted 1.

EMERGENCY CONTACT INFORMATION

Name Address Phone Number Relationship

I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may, at the discretion of the employer, be terminated at any time without any previous notice.

Signed: ______Date: ______