R.H. Cowan Co Application

R.H. Cowan Co., LLC

Employment Application
Date of application Social Security number

MonthDayYear
Date
Name
Last, Frist Middle
Address

Address City

Street Address Line 2

CityState ZIP

Postal / Zip Code
Email
example@example.com
Availability for Work:

Full TimePart TimeTemporaryOvertime Any shift
On what date would you be available to work?
Position desired
Salary/Hourly Rate expected
Are you on layoff from and subject to recall by another employer?

NoYes; If yes, give date(s) _________
Do you have any relatives or friends who are employed here?

NoYes; Who?
Have you filed an application here before? If yes, when?

MonthDayYear
Date
Have you ever been employed here before? If yes, when?

MonthDayYear
Date
Why do you think you would make a valuable employee at R.H. Cowan Co., LLC?
Are you legally authorized to work in the United States?

YesNoWill you now or in the future require sponsorship for employment visa status (e.g., H-1B visa status)? _______
Are you 18 years or older?

YesNo
Have you been convicted of or pled guilty to a felony or misdemeanor other than a minor traffic-related infraction? (A conviction or plea will not necessarily disqualify you from consideration for employment. The effect of a conviction will be assessed with respect to time, circumstances, seriousness of the offense and job responsibilities and duties. However, your failure to list a conviction will disqualify you from consideration for employment or will result in termination if subsequently discovered.)

NoYes; Explain:

Education

	name of school city & state	number of years completed	Graduated	Incomplete	course pursued/ degree granted
High School
Technical/Trade/Business
College/University

Special job-related skills, software and qualifications acquired from education, employment, volunteer work or military service
Specific skills or office machines, tools, machinery or other equipment on which you are trained that will be helpful in performing the responsibilities of the position(s) for which you are applying
Employment History
Starting with your present or most recent job, list all your employment experience for at least the last 15 years. You may include job-related military service assignments and volunteer activities that reflect your qualifications for employment.

Employment History

	Company:	Address:	Telephone #:	Job Title:	Employment Dates:	Salary/Hourly Rate:	Kind of work performed:	Reason for leaving:
Employer 1
Employer 2
Employer 3
Employer 4

Can we contact the employers listed above? Y/N
If you answered no above, state the reason(s) why.
Please list (2) professional and (1) personal reference and their contact information.
Name, Relationship, Phone number
Have you ever been discharged, permitted to resign rather than be discharged, or asked to resign from any position?

NoYes; If yes, please state the employer and the reason for the discharge or resignation.
Which of your previous jobs did you like the most and why?
Which of your previous jobs did you like the least and why?
I certify that this application was completed by me and that all entries and information on it are true
Digital Signature
This application will not be considered active after 60 days.
Should be Empty:

R.H. Cowan Co., LLC

Employment History