New Employee Application Form

BUILDING BRIDGES THROUGH MUSIC

"Educate, Engage, Empower"
Name

First NameMiddle NameLast Name
DOB

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
APPLICANT INFORMATION
Are you a citizen of the United States?

YesNo
If no, are you authorized to work in the U.S.?

YesNo
Have you ever worked for this organization?

YesNo
If yes explain
Have you ever been convicted of a felony?

YesNo
If yes explain
EDUCATION
High School
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Did you graduate?

YesNo
Degree
College
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Did you graduate?

YesNo
Degree
Other
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Did you graduate?

YesNo
Degree
REFERENCES

Please list three professional references
Name

First NameLast Name
Relationship
Company
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Relationship
Company
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Relationship
Company
Phone Number
Please enter a valid phone number.
PREVIOUS EMPLOYMENT
Company
Phone
Address
Supervisor
Job Title
Responsibilities
Starting Salary
Ending Salary
From

MonthDayYear
Date
To

MonthDayYear
Date
Reason for leaving
May we contact your previous supervisor for a reference?

YesNo
Company
Phone
Address
Supervisor
Job Title
Responsibilities
Starting Salary
Ending Salary
From

MonthDayYear
Date
To

MonthDayYear
Date
Reason for leaving
May we contact your previous supervisor for a reference?

YesNo
Company
Phone
Address
Supervisor
Job Title
Responsibilities
Starting Salary
Ending Salary
From

MonthDayYear
Date
To

MonthDayYear
Date
Reason for leaving
May we contact your previous supervisor for a reference?

YesNo
MILITARY SERVICE
Branch
Rank at Discharge
Type of Discharge
If other than honorable, explain
To

MonthDayYear
Date
From

MonthDayYear
Date
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

BUILDING BRIDGES THROUGH MUSIC

APPLICANT INFORMATION

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

MILITARY SERVICE

DISCLAIMER AND SIGNATURE