Employment Application
Name and Street Address, City, State, Zip
Phone Number
E-mail address
Previous address and dates of residence for last 7 years
Why are you applying for this position?
Are you a U.S. Citizen? (We use E-Verify to verify employment elgibility)Yes
No
Are you 18 years old or older?Yes
No
Can you pass a drug test?Yes
No
Can you pass a background test?Yes
No
Have you been convicted of a felony?Yes
No
Do you have reliable transportation and insurance?Yes
No
Do you have a cell phone?Yes
No
Employment History
Employer #1 - Name and address
Employer #1 - Phone number
Employer #1 - Starting and ending salary
Employer #1 - Start date
Employer #1 - End date
Employer #1 - Job duties
Employer #1 - Reason for leaving
Employer #2 - Name and address
Employer #2 - Phone number
Employer #2 - Starting and ending salary
Employer #2 - Start date
Employer #2 - End date
Employer #2 - Job duties
Employer #2 - Reason for leaving
Personal and Professional References - No Family References
Reference #1 - Name, Phone Number, Relationship
Reference #2 - Name, Phone Number, Relationship
Reference #3 - Name, Phone Number, Relationship
Character Traits
Describe your plans for the future:
Are you a team player? Why?
Describe an ethical person?
Do you have attention to detail? Explain:
Do you have work ethics? Describe it:
Why should we hire you?
Details
We only hire PART-TIME that is LESS than 25 hours. Are you available for PART-TIME hours only?Yes
No
Number of hours available
Date available to start
By typing your signature, you state that the above statements are true and accurate.
If your application meets our criteria, you will be contacted via email. We will complete an interview with you, possibly over the phone followed by a working interview.
