Employment Application
Employment Application
Employment Application
1-14-16
DATE ________________________________
Schmidt
Jenna
Elizabeth
Name ______________________________________________________________________________________________
Last
First
Middle
Maiden
1251
400th St.
Kensett IA 50448
Present address ______________________________________________________________________________________
Number
Street
City
State
Zip
482 _____
27 _________
5700
Social Security No. _______
17 years
How long ____________________
Telephone ( 641 ) 845-2471
17 years
If under 18, please list age _____________________
Days/hours available to work
X
No Pref _______
Thur ________
Mon __________ Fri __________
Tue __________ Sat _________
Wed _________ Sun ________
Teller
Position applied for (1) ________________________
Negotiable
and salary desired (2) ________________________
(Be specific)
5-25
Yes
How many hours can you work weekly? _________________________
Can you work nights? _______________________
Employment desired
X PART-TIME ONLY
__
__ FULL-TIME ONLY
__ FULL- OR PART-TIME
____________________________________________________________________________________________________
TYPE OF SCHOOL
High School
NAME OF SCHOOL
Northwood-Kensett
LOCATION
(Complete mailing
address)
704 7th St. N
Northwood, Iowa 50459
NUMBER OF YEARS
COMPLETED
MAJOR &
DEGREE
High School Diploma
3.5
College
Bus. or Trade School
Professional School
X 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. __________________________________________________
____________________________________________________________________________________________________
X Yes __ No
__
Personal vehicle
What is your means of transportation to work? _______________________________________________________________
Drivers license
xxx-xxx-xxx
IA
number ____________________________
State of issue _______
4-14-16
Expiration date ______________________
Have you had any accidents during the past three years?
Have you had any moving violations during the past three years?
__ Chauffeur
2
How many? ___________________
1
How Many? ___________________
OFFICE ONLY
Typing
__ Yes
__ No
Personal
Computer
__ Yes
__ No
_____ WPM
__ Yes
10-key __ No
__ PC
__ Mac
Word
Processing
__ Yes
__ No
_____ WPM
Other _____________________________________________
Skills ______________________________________________
Morgan Johnson
Name _____________________________________________
Teacher
Position ______________________________________
Librarian Associate
Position ___________________________________________
Northwood-Kensett Schools
Company _____________________________________
Northwood-Kensett Schools
Company __________________________________________
Northwood, IA 50459
______________________________________
Northwood, IA 50459
___________________________________________
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.
X No
__ Yes __
X No
__ Yes __
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
City, State, Zip Code
Phone number
Name of last
supervisor
Joann Fox
Employment dates
From 06/22/13
To
06/16
Pay or salary
Start $7.25/hr
Final $7.25/hr
Teller
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this
company.
I held the position as a part-time teller. This job included using computer systems to
run deposits, withdrawals, money transfers, and cashed checks. This included using
typing skills and money handling.
Name of employer
Address
City, State, Zip Code
Phone number
Name of last
supervisor
Employment dates
Pay or salary
From
Start
To
Final
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
City, State, Zip Code
Phone number
Name of last
supervisor
Employment dates
Pay or salary
From
Start
To
Final
Name of employer
Address
City, State, Zip Code
Phone number
Name of last
supervisor
Employment dates
Pay or salary
From
Start
To
Final
__ Yes __ No
__ Yes __ No