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Employment Application: Personal and Background Information

This document is an employment application that requests personal and background information, education and training details, employment history, and references from applicants. It informs applicants that incomplete applications will not be considered and accommodations for disabilities can be requested. Applicants are asked if they are legally authorized to work, have been convicted of crimes, and are at least 18 years old. Their eligibility to drive vehicles is also assessed.

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riverkar06
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
55 views

Employment Application: Personal and Background Information

This document is an employment application that requests personal and background information, education and training details, employment history, and references from applicants. It informs applicants that incomplete applications will not be considered and accommodations for disabilities can be requested. Applicants are asked if they are legally authorized to work, have been convicted of crimes, and are at least 18 years old. Their eligibility to drive vehicles is also assessed.

Uploaded by

riverkar06
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EMPLOYMENT APPLICATION

Thank you for your interest. So that we will have all the information needed to give your application the attention it
deserves, please be sure to read each section and complete it carefully. Do not reference resume. Incomplete
applications will NOT be considered. If you require accommodation due to a disability in order to complete the
application process, please let us know what accommodation you require.

PERSONAL AND BACKGROUND INFORMATION


Name (Last, First, MI) Telephone (day)
( )
Street Address Telephone (evening)
( )
City State Email:
Zip

Position(s) Applying for : Salary Desired: $_________

Schedule Desired:  Full-Time  Part-Time  Summer  Evening

Are you available to work evenings, weekends and/or holidays?  Yes  No


If yes, please specify:

Have you been employed by us before?  Yes  No


If so, when and in what position(s)?

Do you have any relatives working for our company?  Yes  No


If so, please list, with relationships.

Are you legally eligible to work in this country? Are you age 18 or older?
 Yes  No
If you are under 18, please indicate age and
 Yes  No date of birth:

If you are under 18, do you have working


papers?
 Yes  No

Have you ever been convicted of a crime? (Conviction is not necessarily a disqualification for
employment.)
 Yes  No
If you answered “yes,” please attach a separate page describing the nature of the offense(s), the
date(s) of the conviction(s) and the nature of any rehabilitation.

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EMPLOYMENT APPLICATION

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EMPLOYMENT APPLICATION
EDUCATION AND TRAINING
NO. OF DEGREE EARNED
LEVEL SCHOOL CITY STATE YEARS or NUMBER CREDITS GPA
High
School
Technical

College

College

Graduate

Graduate

Other

Please list all Specialized Certificates or Degrees you have earned.


Degree / Certificate Subject School City & State

If you are applying for a job which will entail transporting students and/or driving a College vehicle,
please answer the following:
Do you have a Driver’s License?  Yes  No
Do you have a Public Service License?  Yes  No
Do you have a Commercial Drivers  Yes  No
License?

Optional: Do you speak, read, or write a language other than English? Speak Read Write
 Yes  No
Language:
Language:

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EMPLOYMENT APPLICATION
EMPLOYMENT HISTORY

List all employment in order, beginning with current or most recent. Include military experience if
applicable. Do not reference resume. Attach additional pages if necessary

Employer Dates of Employment (month, year)


Salary / Wage
From: To: Start: End:
Mailing Address Position Type of Organization

City State Duties

Telephone Number
( )
Supervisor’s Name Reason for Leaving
May we contact for reference?  Yes 

Employer Dates of Employment (month, year)


Salary / Wage
From: To: Start: End:
Mailing Address Position Type of Organization

City State Duties

Telephone Number
( )
Supervisor’s Name Reason for Leaving

Employer Dates of Employment (month, year)


Salary / Wage
From: To: Start: End:
Mailing Address Position Type of Organization

City State Duties

Telephone Number
( )
Supervisor’s Name Reason for Leaving

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EMPLOYMENT APPLICATION
REFERENCES

Please list at least three employment references and two personal references (non-relatives) that you give
permission for us to contact.

Name Address Telephone Number How How Associated?


Long
Known?
( )
Employment:
( )
Employment:
( )
Employment:
( )
Personal:
( )
Personal:
( )
Personal:

We appreciate your willingness to voluntarily comply with our request to complete this
confidential survey. It will be kept separate from your employment application and will have
no bearing on hiring decisions.

Name (printed): Date:

Position Seeking:

HOW DID YOU LEARN ABOUT THE POSITION FOR WHICH YOU ARE APPLYING?

Location of Posting / Name of Referral Source


Posting
Newspaper Advertisement
Referral
Job Fair / Open House
Walk-in
Other: _______________________

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