Application for Employment

APPLICATION FOR EMPLOYMENT We are an equal opportunity employer, dedicated to a policy of nondiscrimination in employment on any basis including race, color, age, sex, religion, disability, or national origin. APPLICANT INFORMATION Last Name

     

Street Address City

     

Phone (s)

     

Date Available

First

Dat e Apartment/Unit #

     

M.I.

      State E-mail Address Last four digits of SSN

     

Position Applied       for Are you a citizen of the United States? Have you ever worked for this company?

YES

NO

YES

NO

Are you employed now?

YES

NO

Type of Employment

Full-time

     

ZIP

   

           

     

      XXX – XX–      

Desired Salary

If no, are you authorized to work in the U.S.? If so,       when? If so, may we contact your employer? Part-time

Summer

$     

YES

NO

YES

NO

Temporary

EDUCATION AND OFFICE SKILLS High School

     

From

    

College or Trade School

     

From

    

Years of Typing Experience

To

To

Did you graduate?

    

Did you graduate?

    

     

Computer Software and Hardware Experience

Words Per Minute

     

Address

     

YES

NO

Address

     

YES

NO

Other Office Equipment Used

     

Degree Printer

Copier

     

Phone

Address

     

Name and Position of Supervisor

Job Title

     

Starting Salary

From

To

     

     

Reason for Leaving

May we contact your previous supervisor for a reference?

WFSCT (09-20-2010)

Scanner

(LIST PRESENT OR MOST RECENT

Compan y

     

Fax

     

EMPLOYMENT HISTORY POSITIONS FIRST)

Responsibilities

     

            Ending Salary

$     

      YES

NO

     

$     

Calculator

EMPLOYMENT HISTORY

(CONTINUED)

Compan y

     

Phone

Address

     

Name and Position of Supervisor

Job Title

     

Starting Salary

Responsibilities

     

From

To

     

     

Reason for Leaving

May we contact your previous supervisor for a reference? Compan       y Address

     

Job Title

     

From

To

     

YES

Reason for Leaving

May we contact your previous supervisor for a reference? Compan       y Address

     

Job Title

     

From

To

     

YES

Reason for Leaving

May we contact your previous supervisor for a reference?

$     

     

Phone

     

Ending Salary

$     

Ending Salary

$     

     

$     

     

Starting Salary      

     

NO

NO

     

Phone

     

Name and Position of Supervisor

Responsibilities

Ending Salary

     

Starting Salary      

     

$     

Name and Position of Supervisor

Responsibilities      

     

     

$     

      YES

NO

     

MILITARY SERVICE Branch

     

Rank at Discharge

From

Type of Discharge

     

If other than honorable, explain

     

To

     

     

     

DISCLAIMER AND SIGNATURE I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Signatur e

WFSCT (09-20-2010)

Date