APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

Date: 02/15/2019 Social Security Number:
Name:

Street Address:
City/State/Zip: / /
Phone:
E-Mail:
Referred by:
Are you at least 18 years of age? Yes No
Are you a U.S. Veteran? Yes No


DESIRED EMPLOYMENT

Full Time Part Time
Position:
Date you can start:
Desired Salary:
Present Employment:
May We Contact Your Present Employer? Yes No
Supervisor:
Phone:


EDUCATION

School
Level
Name and
Location of School
Years
Attended*
Date
Graduated*
Subjects
Studied
High School

*The Age Discrimination in Employment Act prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than age 70.

FORMER EMPLOYERS

Date
Month and Year
Name and
Location of Employer
Salary
Position
Reason for Leaving
From:
To:
From:
To:
From:
To:
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

HAVE YOU EVER BEEN CONVICTED OF A CRIME, OTHER THAN MINOR TRAFFIC OFFENSES?

No Yes

GETTING TO KNOW YOU BETTER!!

What does your dream job look like to you? And what would you be doing?


What are your strongest qualities? How have you benefited from them?


What are two of your biggest weaknesses? What have you done to overcome them?


Tell me about your favorite job from the past. What where you doing that made you happy?


Tell me about your least favorite job. What were you doing that made you unhappy?


Are goals important to you? How have they helped you?


Why should we hire you?


How do you think other people view you?


How do you view yourself?


How would you confront a fellow employee if you saw them performing less than acceptable work?


I certify that the information contained in this application is accurate and correct. I understand that any omission or erroneous information may be grounds for dismissal. I authorize the references listed above to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release all parties from all liability that may result from furnishing the same to you. These policies do not create any promises or contractual obligations between this company and its employees. My employment is at will, which means I am free to terminate my employment at any time, for any reason, with or without cause, and the company has the same right.

Signature: (type your full name)


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