Employment Application

    Date

    Position Desired

    Legal Name

    Email

    Address

    Phone

    Cell Phone

    Eligible to work in US

    Emergency Contact

    Phone

    Have you ever been convicted of a felony or misdemeanor?

    Education (List where attended, dates attended/graduated, diploma/degrees recd)

    High School

    College

    Technical School

    Military/Other

    Scholarships/Awards/Honors

    Computer Skills/Training

    Hobbies & Interests

    Type of Work Preferred

    Full or Part-Time

    Salary Desired

    Are you willing to work on Saturdays when needed?

    Job Experience

    First Employer

    Employer Name

    Employer Phone No.

    Date of Employment

    Title

    Salary

    Second Employer

    Employer Name

    Employer Phone No.

    Date of Employment

    Title

    Salary

    Third Employer

    Employer Name

    Employer Phone No.

    Date of Employment

    Title

    Salary

    Work Reference 1 (Co-Worker, Customer, Vendor)

    Name

    Occupation

    Phone

    Work Reference 2 (Co-Worker, Customer, Vendor)

    Name

    Occupation

    Phone

    Personal References: Do not list relatives or former employers

    First Person

    Name

    Occupation

    Phone

    Second Person

    Name

    Occupation

    Phone

    General Questions

    Would you prefer public or private praise for successful completion of tasks?

    Please describe a time when someone encouraged you in a meaningful way