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Application for Employment
(An Equal Opportunity Employer) |
DATE:
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| Please send my application to: |
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| PERSONAL INFORMATION: |
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| Phone Number: * |
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Email Address: |
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| Are you 18 years or older?* |
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| Are you either a U.S. Citizen or an Alien authorized to work in the United States?* |
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| Have you ever been convicted of a crime?* |
If yes please explain: |
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| POSITION INFORMATION : |
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Salary
Desired: |
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Date you
can start: |
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Are you
employed now?: |
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If so, may we inquire of your present employer?: |
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| Have you ever applied to this company before? |
| Where?: |
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When?: |
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| EMPLOYMENT HISTORY: |
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Dates of
Employment |
Name and Address
of Employer |
Salary |
Position |
Reason
for Leaving |
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Which of these jobs did you like best? |
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What did you like most about that job? |
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| EDUCATION: |
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Subjects of special study or research work : |
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Special skills: |
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Current Activities:
(exclude organizations, the name of which indicates the race, creed, sex, age, marital status or nation of origin of its members) |
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REFERENCES:
Give the names of three persons, not related to you, whom you have known for at least one year and whom we may contact: |
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| Name Known |
Address |
Phone Number |
Business |
Years |
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IN CASE OF EMERGENCY NOTIFY: |
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| Name |
Address |
Phone Number |
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“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing the same to you.
I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause."
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