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Sample Employment Application Form

The applicant is applying for a laborer position and has included an employment application form with personal and employment details. They are currently employed at Burger King and have also previously worked at Fallgatters grocery store. They have a high school diploma and do not have any criminal convictions. They are available to work part-time and have reliable transportation.

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82 views4 pages

Sample Employment Application Form

The applicant is applying for a laborer position and has included an employment application form with personal and employment details. They are currently employed at Burger King and have also previously worked at Fallgatters grocery store. They have a high school diploma and do not have any criminal convictions. They are available to work part-time and have reliable transportation.

Uploaded by

api-308142052
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Sample Employment Application Form

PLEASE PRINT ALL


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

PLEASE COMPLETE PAGES 1-4.

DATE ________________________________

Hemenway
Alexander
J
Name ______________________________________________________________________________________________
Last

Present address

First

Number

Street

4 years
How long ____________________

Telephone (

Middle

Maiden

520
Central Ave Northwood, IA
50459
______________________________________________________________________________________
City

State

Zip

Social Security No. _______ _____ _________

If under 18, please list age _____________________


Days/hours available to work
No Pref _______ Thur ________
Mon __________ Fri __________
Tue __________ Sat _________
Wed _________ Sun ________

Laborer
Position applied for (1) ________________________
Negotiable
and salary desired (2) ________________________
(Be specific)

Yes
30
How many hours can you work weekly? _________________________
Can you work nights? _______________________

Employment desired

X PART-TIME ONLY
__

__ FULL-TIME ONLY

__ FULL- OR PART-TIME

ASAP
When available for work?_______________

____________________________________________________________________________________________________

TYPE OF SCHOOL

High School

NAME OF SCHOOL

LOCATION
(Complete mailing
address)

Northwood High School

NUMBER OF YEARS
COMPLETED
3

MAJOR &
DEGREE
Diploma, May 2016

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?

__ Yes __
X No

Friend
What is your means of transportation to work? _______________________________________________________________

Drivers license
X
X
number ____________________________
State of issue _______
X
Expiration date ______________________

__ Operator __ Commercial (CDL)

No
Have you had any accidents during the past three years?
No
Have you had any moving violations during the past three years?

__ Chauffeur

How many? ___________________


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.


Austin Simons
Name _______________________________________

Name _____________________________________________

Driver
Position ______________________________________

Position ___________________________________________

Pizza Hut
Company _____________________________________

Company __________________________________________

1118 Janee Ave.


Address ______________________________________

Address ___________________________________________

______________________________________

___________________________________________

Telephone (

Telephone (

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 Yes __ No
__
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

Fallgatters
98 7th St N
Northwood, IA 50459
(641) 324-1651

Name of last
supervisor

Kevin Petznick

Your last job title


Reason for leaving (be specific)

Employment dates

Pay or salary

From Nov. 2014

Start 7.50/Hour

To

Final 7.50/Hour

June 2015

Carry out

Bad Management

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this
company.
Stock Shelves, Carry groceries, Customer Assistance, Bag Items,
Shovel snow and salt pavement (winter)

Name of employer
Address
City, State, Zip Code
Phone number

Burger King
700 Diamond Jo Ln
Northwood, IA 50459
(641) 324-1366

Name of last
supervisor

Employment dates
From

Kevin

Your Last Job Title

To

Sept. 2015
Present

Pay or salary
Start

7.25/Hour

Final

7.50/Hour

Crew member

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.
Make food, clean kitchen, clean bathrooms, take out trash, wash dishes

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?

X
__ Yes __ No

Did you complete this application yourself

X Yes __ No
__

If not, who did? _______________________________________________________________________________________

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