applicaton

Sample Employment Application Form

PLEASE PRINT ALL INFORMATION REQUESTED

EXCEPT SIGNATURE

APPLICATION FOR EMPLOYMENT

APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS

PLEASE COMPLETE PAGES 1-4. DATE ________________________________

Name ______________________________________________________________________________________________ Last First Middle Maiden

Present address ______________________________________________________________________________________ Number Street City State Zip

How long ____________________ Social Security No. _______ – _____ – _________

Telephone ( )

If under 18, please list age _____________________

Position applied for (1) ________________________ and salary desired (2) ________________________ (Be specific)

Days/hours available to work No Pref _______ Thur ________ Mon __________ Fri __________ Tue __________ Sat _________ Wed _________ Sun ________

How many hours can you work weekly? _________________________ Can you work nights? _______________________

Employment desired __ FULL-TIME ONLY __ PART-TIME ONLY __ FULL- OR PART-TIME

When available for work?_______________

____________________________________________________________________________________________________

TYPE OF SCHOOL NAME OF SCHOOL LOCATION (Complete mailing

address)

NUMBER OF YEARS COMPLETED

MAJOR & DEGREE

High School

College

Bus. or Trade School

Professional School

HAVE YOU EVER BEEN CONVICTED OF A CRIME? __ No __ Yes

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. __________________________________________________

____________________________________________________________________________________________________

PLEASE PRINT ALL INFORMATION REQUESTED

EXCEPT SIGNATURE APPLICATION FOR EMPLOYMENT

DO YOU HAVE A DRIVER’S LICENSE? __ Yes __ No

What is your means of transportation to work? _______________________________________________________________

Driver’s license number ____________________________ State of issue _______ __ Operator __ Commercial (CDL) __ Chauffeur Expiration date ______________________

Have you had any accidents during the past three years? How many? ___________________ Have you had any moving violations during the past three years? How Many? ___________________

OFFICE ONLY

__ Yes __ Yes Word __ Yes Typing __ No _____ WPM 10-key __ No Processing __ No _____ WPM

Personal __ Yes __ PC Computer __ No __ Mac

Other _____________________________________________ Skills ______________________________________________

Please list two references other than relatives or previous employers.

Name _______________________________________ Name _____________________________________________

Position ______________________________________ Position ___________________________________________

Company _____________________________________ Company __________________________________________

Address ______________________________________ Address ___________________________________________

______________________________________ ___________________________________________

Telephone ( ) Telephone ( )

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

PLEASE PRINT ALL INFORMATION REQUESTED

EXCEPT SIGNATURE

APPLICATION FOR EMPLOYMENT

MILITARY

HAVE YOU EVER BEEN IN THE ARMED FORCES? __ Yes __ No

ARE YOU NOW A MEMBER OF THE NATIONAL GUARD? __ Yes __ No

Specialty ___________________________________ Date Entered ________________ Discharge Date ______________

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.

Name of employer Address

Name of last supervisor

Employment dates Pay or salary

City, State, Zip Code Phone number From

To

Start

Final

Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of employer Address

Name of last supervisor

Employment dates Pay or salary

City, State, Zip Code Phone number From

To

Start

Final

Your Last Job Title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

PLEASE PRINT ALL INFORMATION REQUESTED

EXCEPT SIGNATURE

APPLICATION FOR EMPLOYMENT

Work experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.

Name of employer Address

Name of last supervisor

Employment dates Pay or salary

City, State, Zip Code Phone number From

To

Start

Final

Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of employer Address

Name of last supervisor

Employment dates Pay or salary

City, State, Zip Code Phone number From

To

Start

Final

Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your present employer? __ Yes __ No

Did you complete this application yourself __ Yes __ No

If not, who did? _______________________________________________________________________________________