![]() The pay rate that is expected by the Job Applicant can be defined as a dollar amount paid by the hour or a set yearly salary. The calendar date when the Job Applicant is first able to physically work should be reported. Therefore, a specific area has been reserved for the Job Applicant’s social security number to be displayed. A generally accepted and extremely reliable means of verifying one’s identity is his or her social security number. The Job Applicant’s cell phone and/or home phone number(s) should be displayed with his or her other contact information. Many potential Employers will contact the Applicant by telephone for important matters, questions, or decisions. The Job Applicant should be able to provide a valid email address that is actively monitored. ![]() Most if not all Employers will need the home address of each potential Employee to support a background check. The Job Applicant’s residential address must be distributed to the next area. His or her name is expected in the standard presentation of “First,” “Middle,” and “Last” where requested. The Job Applicant, who will submit this application, will need to be identified at the beginning of this process. PRINT NAME: _ How to Fill Out a Job Applicationĭownload in PDF, Microsoft Word (.docx) or Open Document Text (.odt). If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my termination. I, the undersigned, certify that my answers are true and honest to the best of my knowledge. Please complete each section, EVEN IF you decide to attach a resume. To ensure this application is acceptable, it is recommended to type and print your details. ![]() IF ASKED, WOULD YOU CONSENT TO A BACKGROUND CHECK? ☐ YES ☐ NOĪpplicant understands that this is an equal opportunity employer and is committed to excellence through diversity. REFERENCE #3: RELATIONSHIP: COMPANY: TITLE: E-MAIL: PHONE: ĪRE YOU A VETERAN? ☐ YES ☐ NO BRANCH: RANK AT DISCHARGE: FROM: TO: TYPE OF DISCHARGE: IF NOT HONORABLE, PLEASE EXPLAIN: REFERENCE #2: RELATIONSHIP: COMPANY: TITLE: E-MAIL: PHONE: REFERENCE #1: RELATIONSHIP: COMPANY: TITLE: E-MAIL: PHONE: REFERENCES (PROFESSIONAL ONLY, NO FAMILY MEMBERS). OTHER: CITY / STATE: FROM: TO: DEGREE/CERTIFICATION: ĮMPLOYER #1: E-MAIL: PHONE: ADDRESS: START: $ ☐ HOUR ☐ SALARY END: $ ☐ HOUR ☐ SALARY JOB TITLE: RESPONSIBILITIES: FROM: TO: REASON FOR LEAVING: ĮMPLOYER #2: E-MAIL: PHONE: ADDRESS: START: $ ☐ HOUR ☐ SALARY END: $ ☐ HOUR ☐ SALARY JOB TITLE: RESPONSIBILITIES: FROM: TO: REASON FOR LEAVING: ĮMPLOYER #3: E-MAIL: PHONE: ADDRESS: START: $ ☐ HOUR ☐ SALARY END: $ ☐ HOUR ☐ SALARY JOB TITLE: RESPONSIBILITIES: FROM: TO: REASON FOR LEAVING: HIGH SCHOOL: CITY / STATE: FROM: TO: GRADUATE? ☐ YES ☐ NO DIPLOMA: ĬOLLEGE: CITY / STATE: FROM: TO: GRADUATE? ☐ YES ☐ NO DEGREE: FULL NAME: DATE: ADDRESS: E-MAIL: PHONE: SOCIAL SECURITY NUMBER (SSN): DATE AVAILABLE: DESIRED PAY: $ ☐ HOUR ☐ SALARY POSITION APPLIED FOR: EMPLOYMENT DESIRED: ☐ FULL-TIME ☐ PART-TIME ☐ SEASONALĪRE YOU LEGALLY ELIGIBLE TO WORK IN THE U.S? ☐ YES ☐ NO HAVE YOU EVER WORKED FOR THIS EMPLOYER? ☐ YES ☐ NO – IF YES, WRITE THE START AND END DATES: to HAVE YOU EVER BEEN CONVICTED OF A FELONY? ☐ YES ☐ NO -IF YES, PLEASE EXPLAIN:
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