Employment ApplicationApplicant InformationApplicant Name * Home Phone*Other Email Address* Current AddressNumber and streetCityState & ZipHow were you referred to Company? Employment PositionsPosition(s) applying for Are you applying for:Temporary work – such as summer or holiday work? Y N Regular part-time work? Y N Regular full-time work? Y N What days and hours are you available for work?If applying for temporary work, when will you be available? If hired, on what date can you start working? MM DD YYYY The majority of hours available consist of weekend hours. What hours are you available on weekends? Can you work evenings? Y N Are you available to work overtime? Y N Salary desired $Personal InformationHave you ever applied to / worked for Company before? Y N If yes, please explain (include date) Do you have any friends, relatives, or acquaintances working for Company? Y N If yes, state name & relationship If hired, would you have transportation to/from work? Y N How many moving violations have you had in the last five years? Please list all, including date of offense.Are you over the age of 21? (If under 21, hire is subject to verification of minimum legal age. Y N If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States? Y N If hired, are you willing to submit to and pass a controlled substance test? Y N Heavy Lifting is required for our positions. Are you able to perform the essential functions of the job for which you are applying? Y N If no, describe the functions that cannot be performedHave you ever been convicted of a criminal offense (felony or misdemeanor)? Y N If yes, please describe the crime - state nature of the crime(s), when and where convicted and disposition of the case. Education, Training and ExperienceHigh SchoolSchool name School addressSchool city, state, zipNumber of years completedDid you graduate? Y N Degree / diploma earnedCollege / UniversitySchool nameSchool addressSchool city, state, zipNumber of years completedDid you graduate? Y N Degree / diploma earned Vocational School Name Address City, state, zipNumber of years completedDid you graduate? Y N Degree / diploma?MilitaryBranchRank in Military Total Years of Service Skills/dutiesRelated detailsDo you have any other experience, training, qualifications, or skills which you feel should be brought to our attention, in the case that they make you especially suited for working with us? Y N If yes, please explainEmployment HistoryAre you currently employed? Y N If you are currently employed, may we contact your current employer? Y N Below, please describe past and present employment positions, dating back five years. Please account for all periods of unemployment.Name of EmployerName of Supervisor Telephone NumberBusiness TypeAddress City, state, zipLength of Employment (Include Dates) Position & DutiesReason for LeavingMay we contact this employer for references? Y N Name of Previous EmployerName of SupervisorTelephone Number Business TypeAddressCity, state, zipLength of Employment (Include Dates)Position & DutiesReason for LeavingMay we contact this employer for references? Y N Even if you have attached a resume, this section must be completed.Resume File Δ
