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Application
Personal
Full Name
Address
City, State Zip
Phone Number
Email
If employed and under 18 years, can you furnish a work permit?
If hired, do you have reliable transportation?
Do you have a valid drivers license?
Drivers license number, state and type
If required, would you be willing to have a drug test done?
If hired, can you provide proof of your legal right to work in this country?
Have you ever been convicted of any crime (excluding minor traffic violations) including DWI?
If answered Yes, please explain?
Employment
Are you currently employed?
If yes, may we contact your present employer as to work performance?
On what date would you be avaliable for work?
Are there any hours you would be unable or unwilling to work?
If yes, please specify those days or hours you would be unable or unwilling to work?
Education
High School
Dates
Graduate?
College or Technical School
Dates
Graduate
If you did not graduate, why did you leave high school or college?
List and describe any other school or specialized training
Military
Have you ever served in the military?
Service Branch
Dates
Work History
Name of Employer
Address
Phone Number
Supervisor
Dates Employed
Nature of Business
Starting Salary
Ending Salary
Title/Position
Reason for Leaving
May we Contact?
Name of Employer
Address
Phone Number
Supervisor
Dates Employed
Nature of Business
Starting Salary
Ending Salary
Title/Position
Reason for Leaving
May we Contact?
References
Name, Years Know, Telephone Number
Name, Years Know, Telephone Number
Name, Years Know, Telephone Number
Resume
(Make sure your filename does not contain any special characters)
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given to me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
I understand that nothing contained in the application or conveyed during any interview which may be granted is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determined period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and that no promises or representation contrary to the foregoing are binding on the company unless made in writing and signed by me and the company’s representative.
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