Employment

Application For Employment

Date

Directions

Directions: Type or print in blue or black ink. Answer all questions which are applicable. Please do not state “See Resume”.

PERSONAL INFORMATION

Last Name

First Name

Middle

Address

City

State

Zip

Phone

Day Phone (if Different)

Social Security Number

Fax Number

E-Mail Address

EMPLOYMENT INFORMATION

Position for which you are applying

Are you employed at the present time?

If yes, please complete the information below

Employer’s Name

Employer’s Address

1. How long have you been with this employer?

Present Salary

2. If offered a position, when can you report for work?

3. If hired can you show proof of your legal right to work in the U.S.?

Yes

4. Have you ever been dismissed, or asked to resign from any position?

Yes

5. Have you ever been convicted of a felony, or a misdemeanor which resulted in imprisonment?

Yes

A yes answer to the above question does not necessarily disqualify an applicant from employment

If yes to number 4 or 5, please explain

EDUCATION

Please list on the following lines all schools attended and any other pertinent information about your education.

High School

Subjects Studied (if applicable)

College (Including dates attended)

Subjects Studied (if applicable)

EMPLOYMENT EXPERIENCE (List most recent experience first)

Name & Address

Position(s) Held

Dates (Start - End)

Name & Address

Position(s) Held

Dates (Start - End)

Name & Address

Position(s) Held

Dates (Start - End)

REFERENCES

Name & Address (Include City, State, Zip)

Phone

Relationship

Name & Address (Include City, State, Zip)

Phone

Relationship

Name & Address (Include City, State, Zip)

Phone

Relationship

The following section is to be completed by applicant for an OFFICE POSITION:

Can you type?

How many words per minute?

Computer Skills - Macintosh

Computer Skills - PC

Please provide computer and software knowledge below

Sign

I certify that all statements made herein and on the enclosed resume are true and correct to the best of my knowledge. I authorize investigation of all statements herein recorded. I release from liability all persons and organizations reporting information required by this application.

Date

Building strong foundations with integrity and excellence since 1976.

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Contact Information

Phone: 989-631-1860

Email: midmich123@gmail.com

Address: 3045 E. Mercantile Drive, Midland MI 48642

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