APPLICATION FOR EMPLOYMENT
(PRE-EMPLOYMENT QUESTIONAIRE) (AN EQUAL OPPORTUNITY EMPLOYER)
PERSONAL INFORMATION
| Last Name
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| First Name
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| Present Address: Street
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| City
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| State
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| Zip Code
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| Permanent Address: Street
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| City
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| State
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| Zip Code
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| Phone No.
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| Are you 18
years of age
or older?
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| Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
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EMPLOYMENT DESIRED
| Position
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| Date you can Start
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| Salary Desired
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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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| Ever applied to this company before?
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| Where?
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| When?
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| Referred by:
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EDUCATION
| Name and Location of School
| *No of Years Attended
| *Did you Graduate?
| Subjects Studied |
| Grammar School
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| High School
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| College
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| Trade, Business, or Correspondence School
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GENERAL
| Subjects of Special Study or Research Work
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| Special Skills
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| Activities(Civic,Athletic, Etc.) Exclude organizations, the name of which indicates the race,creed, sex, age, marital status color or nation of origin of its members. |
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U.S. Military or Naval Service
Rank
Present Membership in National Guard or Reserves
FORMER EMPLOYERS
(List below last three employers, starting with last one first)
Date
Month and Year
| Name and Address of Employer
| Salary
| Position
| Reason for Leaving |
| From
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| To
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| From
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| To
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| From
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| To
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Which of these jobs did you like best?
What did you like most about this job?
REFERENCES
Give the names of three persons not related to you, whom you have known for at least one year.
| NAME
| ADDRESS
| BUSINESS
| YEARS ACQUAINTED |
| 1.
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| 2.
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| 3.
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In case of emergency notify: NAME: ADDRESS: PHONE NUMBER:
I certify that all the information submitted by me on this application
is true and complete,and i understand that any false information, ommisions, or misrepresentations
are discovered, my employment may be terminated at any time.
In consideration of my employment, I agree
to conform to the company's rules and regulations, and I agree that my employment and compensation
can be terminated, with or without cause, at any time, at either my or the company's option. I also
understand and agree that the terms and conditions of my employment may be changed, with or without
cause, and with or without notice, at any time by the company. I understand that no company
representative, other than it's president, and then only when in writing and signed by the
president has any authority to enter into any agreement for employment for any specific period
of time, or to make any agreement contrary to the foregoing."
Do you accept this agreement?