June 14, 2020 Employment Application Apply Online *Full Name0/50*Job Title applying for0/100*Email AddressHome Phone Number0/50*Mobile Phone Number0/50*Home Address0/200*City State and Zip Code0/200Type in your city, state and zip codeMinimum Acceptable Salary0/50Days and Hours you are available to work*Do you have reliable transportation? Yes No *Are you over the age of 18? Yes No *Would you be able to provide proof of citizenship or proof of your legal right to work in the US? Yes No *Are you willing to pass a controlled substance test? Yes No *Are you able to physically able to perform the essential functions of the job you are applying for? Yes No *Do you have any conditions which might prevent you from being able to perform the duties of the position you are applying for? Yes No If you answered yes to the question above, please describe the functions you have a concern about being able to perform0/200*Have you ever been convicted of a criminal offense (felony or misdemeanor)? Yes No If yes, please describe the crime -0/150state nature of the crime(s), when and where convicted and disposition of the case*Name of high school attended, number of years completed, and if you graduated or not along with any diploma earned0/100School name, city and state, number of years completed, graduate yes or no?, diploma or GED earned?Tell us about your college education0/100name of college, city and state, years completed and any degree(s) earnedTell us about your military experience0/100Branch of service, rank attained, years served, skills/duties, last position, type of dischargeDo you have any other qualifications, experience or training which you feel qualifies you for the job?0/100What would make you especially suited for this job?*Are you currently employed? Yes No *May we contact your current/former employers? Yes No *Please tell us about your current/last employer0/500Name of employer, location, supervisor's name, dates of employment, position and duties, reason for leaving, current rate of payPlease tell us about previous employmentName of employer, location, supervisor's name, dates of employment, position and duties, reason for leaving, last rate of payPlease tell us about previous employmentName of employer, location, supervisor's name, dates of employment, position and duties, reason for leaving, current rate of payPlease tell us about previous employmentName of employer, location, supervisor's name, dates of employment, position and duties, reason for leaving, current rate of payPlease tell us about previous employmentName of employer, location, supervisor's name, dates of employment, position and duties, reason for leaving, current rate of payPlease tell us about previous employmentName of employer, location, supervisor's name, dates of employment, position and duties, reason for leaving, current rate of pay*Please give us two or three persons who have knowledge of your work performance within the last four years.Include name, phone number, years acquainted, and how they know you. Do not use family and friends as references. List their contact information.*I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. Yes No I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.*I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice by the company. Yes No *I permit the company to examine my references, record of employment, education record, and any other information I have provided. Yes No I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.*Please type your name as your electronic signature0/50*Date of application Fields with (*) are compulsory. Sam Milo All author posts
