Employment Application

Download as pdf or txt
Download as pdf or txt
You are on page 1of 4

Sample Employment Application Form

PLEASE PRINT ALL


INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS

1-14-16

PLEASE COMPLETE PAGES 1-4.

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

Weekdays and weekends


When available for work?_______________

____________________________________________________________________________________________________

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

HAVE YOU EVER BEEN CONVICTED OF A CRIME?

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. __________________________________________________
____________________________________________________________________________________________________

PLEASE PRINT ALL


INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT

DO YOU HAVE A DRIVERS LICENSE?

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?

X Operator __ Commercial (CDL)


__

__ 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 ______________________________________________

Please list two references other than relatives or previous employers.


Suzanne Bestul
Name _______________________________________

Morgan Johnson
Name _____________________________________________

Teacher
Position ______________________________________

Librarian Associate
Position ___________________________________________

Northwood-Kensett Schools
Company _____________________________________

Northwood-Kensett Schools
Company __________________________________________

704 7th St. N


Address ______________________________________

704 7th St. N


Address ___________________________________________

Northwood, IA 50459
______________________________________

Northwood, IA 50459
___________________________________________

Telephone ( 641) 324-2142

Telephone (641 ) 324-2142

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?

X No
__ Yes __
X No
__ Yes __

ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?

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
City, State, Zip Code
Phone number

Name of last
supervisor
Joann Fox

Employment dates
From 06/22/13
To

Your last job title


Reason for leaving (be specific)

06/16

Pay or salary
Start $7.25/hr
Final $7.25/hr

Teller

Moving away for college

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

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.
I held the position as

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
City, State, Zip Code
Phone number

Name of last
supervisor

Employment dates

Pay or salary

From

Start

To

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
City, State, Zip Code
Phone number

Name of last
supervisor

Employment dates

Pay or salary

From

Start

To

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? _______________________________________________________________________________________

You might also like