Career and Occupations

Company Name

From job application

An employer equal opportunities
Society is an equal opportunity employer. This request will not be used to limit or exclude any applicant for consideration for employment on a basis prohibited by local, state or federal. Applicants requiring reasonable accommodation in the application and / or process should notify a representative of the organization.

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Applicant Information
Applicant Name _____________________
Home Telephone _______________________
Other ____________________________
E-mail _____________________

Present address:
Street and ____________________
City ________________________________
State & Zip ____________________________

How were you referred to ?:___________________________

Posts
Position (s) applying for :________________________________

Are you applying for:

* Temporary work - as the summer vacation or work? [] Y or [] N
* Regular part-time work? [] Y or [] N
* Regular full-time? [] Y or [] N

Whether the days and hours are you available for work ?___________________________________________

If you apply for temporary work, when will you be available? ___________________________________________

If hired, when you can start working? ___ / ___ / ___

Can you work weekends? [] Y or [] N

Can you work in the evening? [] Y or [] N

Are you available to work overtime? [] Y or [] N

Salary desired: $________________________________

Personal information:
Have you ever applied / worked for the company? [] Y or [] N
If yes, please explain (including date): ________________________

Do you have friends, relatives, or acquaintances working for the company? [] Y or [] N
If so, mention the name and relationship: ________________________________

If hired, would you have transportation to or from work? [] Y or [] N

Are you over age 18? (If less than 18 years, the lease is subject to verification of the legal minimum age.) [] Y or [] N

If hired, would you be able to submit evidence of your U.S.
citizenship or proof of your right to work in the USA? [] Y or [] N

If hired, are you ready to submit and pass a test substance? [] Y or [] N

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation? [] Y or [] N

If not, describe the functions that can not be done
_____________________________________________________________

(Note: Company complies with the ADA and consider reasonable accommodation that May be necessary for eligible applicants and employees to perform essential functions. It is possible that a lease May be tested on skills / agility and May be subject to a medical examination by a health professional.)

Have you ever been convicted of an offence (crimes)? [] Y or [] N

If yes, please describe the crime - State nature of the crime (s), when and where convicted and disposition of case.________________________________________________________________

(Note: No candidate will be denied employment solely because of a conviction of a criminal offence. The date of the offence, the nature of the offence, including the important details that affect the event description, and the circumstances and relevance of the offence to the position (s) applied for May, however, be taken into account.)

Education, training and experience
High School:
School name: ________________________
Address school :________________________
School City, state, zip code :________________________________

Number of completed years: _______________
Did you graduate? [] Y or [] N
Graduated: _______________

College / University:
School name: __________________________
Address school :________________________
School City, state, zip code :________________________________

Number of completed years: ________
Did you graduate? [] Y or [] N
Graduated: __________________

Vocational School:
Name: ________________________
Address :______________________
City, state, zip code :________________________________

Number of completed years: ________
Did you graduate? [] Y or [] N
Diploma? : __________________

Military:
Branch: ________________________
Rankings military :________________________
Total number of years of service: ________
Skills / functions: ________
Related details :________________________________