MOTOR CITY SMOOTHIE CO EMPLOYEE APP

MOTOR CITY SMOOTHIE COMPANY Employment Application
Last NAME
First NAME
M.I.
Date

Month Day Year
Date
Street Address
City
State
Phone
Email
example@example.com
Date Available

Month Day Year
Date
Social Security No.
Desired Salary:$
Position Applied for
Are you a citizen of the United States?

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

Have you ever worked for this company?
If yes, when?
Have you ever been convicted of a felony?

YES NO
If yes, explain
High School
Address
From
To
Did you graduate?

YES NO
Diploma;
College
Address
From
To
Did you graduate?

YES NO
Degree
Other
From
To
Did you graduate?

YES NO
Degree
Please list three professional references.
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Company
Phone
Address
Supervisor
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?

YES NO
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary:$
Responsibilities
From
To
Reason for Leaving

YES NO
Reason for Leaving
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary:$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?

YES NO
May we contact your previous supervisor for a reference?
Branch
From
To
Rank at Discharge
Type of Discharge
If other than honorable. explain
/ certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, / understand that false or misleading information in my application or interview may result in my release.
Signature

Clear
Date

Month Day Year
Date
PLEASE PROVIDE COPY OF GOVERNMENT ISSUED ID
Should be Empty:

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