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 Name Lasl Present address City Street Social Security No How long Telephone Stale ( Z)p _ ) lf under 18, please list age Position applied for Davs/hours available to work No Pref Thur Fri Mon Tue Sat Wed Sun (1) _ _ _ and salary desired (2) (Be specific) Can you work nights? How many hours can you work weekly? Employment desired When available for work? TYPE OF SCHOOL - FULL-TIME _ ONLY NAME OF SCHOOL - PART-TIME LUUA I IUN (Complete mailing address) ONLY - FULL- OR PART-TIME NUMBbK UI. YbAKS COMPLETED MAJOR & DEGREE Hiqh School Colleqe Bus. or Trade School Professional School HAVE YOU EVER BEEN CONVICTED OF A CRIME? _No Yes lf 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 REOUESTED EXCEPT SIGNATURE APPLICATION FOR EMPLOYMENT DO YOU HAVE A DRIVER'S LICENSE? What is your means of transportation to work? Yes - No Driver's license number Expiration date State of issue _ _ _ Operator _ years? years? , I OFFICE ONLY Have you had any accidents during the past three Have you had any moving violations during the past three Commercial How many? How Many? (CDL) _ Chauffeur _ I _ Typing _ Personal _ Comouter Yes No Yes No _ WPM _ PC Mac 10-key _ Yes _ No Word _ Yes Processing _ No _ WPM Other Skills Please list two references other than relatives or previous employers. Name Position Company Address Address Telephone( ) Telephone( Name Position _ Company ) 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 FORCES? _ yes _ No yes OF THE NATIONAL GUARD? HAVE YOU EVER BEEN tN THE ARMED ARE YOU NOW A MEMBER Specialty Work Experience No Date Entered Discharge Daie Please list your work experience for the past five years beginning with your most recent job held. lf you were self-employed, give firm name. Attach additional sheets iinecessary. Name of employer Address Name of last supervisor City, State, Zip Code Phone number 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 Name of last su pervisor City, State, Zip Code Phone number 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. t / 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. lf you were self-employed, give flrm name. Attach additional sheets if necessary. Name of employer Address City, State, Zip Code Phone number Your last job tifle Reason for leaving (be specific) List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at thrs company. Name of employer Address City, State, Zip Code Phone number Your last 1ob title Reason for leaving (be specific) List the iobs you held, duties performed, skills used or learned, advancements or promotrons while you worked at this company. May we contact your present employer? Did you complete this application yourself lf not, who did? _Yes _ _Yes _ No No