Clerical Employment Application
Personal Information
Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Apt/Suite
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date Available
*
/
Month
/
Day
Year
Desired Pay
*
Pay Type
*
Hourly
Salary
Position Applied For:
*
Position Type
*
Full-Time
Part-Time
Either
Employment Eligibility
Are you legally eligible to work in the U.S.?
*
Yes
No
Have you been convicted of a felony?
*
Yes
No
If yes, please explain:
Education
High School
City/State
Graduate?
Yes
No
Graduation Year
College
City/State
Graduate?
Yes
No
Graduation Year
Other
City/State
Graduate?
Yes
No
Graduation Year
Previous Employment
References
(Professional Only)
Military Service
Are you a veteran or member of the armed services?
Yes
No
Branch
Rank at Discharge
From
/
Month
/
Day
Year
Date Picker Icon
To
/
Month
/
Day
Year
Date Picker Icon
Type of Discharge
If not honorable, please explain
Background Check Consent
If asked, are you willing to consent to a background check?
*
Yes
No
Resume
Upload Resume
Browse Files
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Disclaimer
Confirmation
*
I certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.
Signature
*
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