EMPLOYMENT APPLICATION FORM (DIGTAL)

EMPLOYMENT APPLICATION
501 S. Florida Alamogordo, NM 88310
DIRECTIONS:
- Print or Type, using black ink or marker
- If you need additional space, attach a supplemental sheet
- Sign the completed application
If you are printing out the form please scroll down to the bottm and click "Preview PDF"
GENERAL
Name*

First NameLast Name
(MIDDLE)*
SOCIAL SECURITY NO.*
DATE OF APPLICATION*

MonthDayYear
Date
PRESENT ADDRESS (STREET CITY STATE ZIP CODE)*
Phone Number (Day)
Please enter a valid phone number.
Phone Number (Evening)
Please enter a valid phone number.
Cell Phone No.*
Please enter a valid phone number.
ADDRESS WHERE YOU MAY BE CONTACTED IF DIFFERENT FROM PRESENT ADDRESS*
IF HIRED, CAN YOU PROVIDE PROOF OF CITIZENSHIP OR LEGAL RIGHT TO WORK?*

YESNO
POSITION
TYPE OF POSITION APPLYING FOR*
SOURCE OF REFERRAL*
DATE AVALABLE*

MonthDayYear
Date
SALARY EXPECTED
Type a question*

FULL TIME (REGULAR)TEMPORARYPART TIME (REGULAR)
SPECIFY ANTICIPATED PERIOD OF WORK AND/OR NUMBER OF HOURS PER DAY*
EXPECTED SALAERY*
Plesse note that the Employment Record, Education & Training and References sections do not need to be completed , an attached resume provides al of the specific requested information if there is information requested that is not on your resume, please be sure to provide that information in order to ensure your application materials will be considered
EMPLOYMENT RECORD
START DATE*

MonthDayYear
Date
END DATE*

MonthDayYear
Date
FINAL POSITION TITLE*
FINAL SALARY*
EMPLOYER*
MAY WE CONTACT THIS EMPLOYER?*

YESNO
LAST SUPERVISORS NAME*
REASON FOR LEAVING*
STREET ADDRESS CITY STATE ZIP CODE*
Phone Number*
Please enter a valid phone number.
POSITION DESCRIPTION*
MAY WE CONTACT THIS EMPLOYER?*

YESNO
START DATE

MonthDayYear
Date
END DATE

MonthDayYear
Date
FINAL POSITION TITLE
FINAL SALARY
EMPLOYER
LAST SUPERVISORS NAME
REASON FOR LEAVING
STREET ADDRESS CITY STATE ZIP CODE
Phone Number
Please enter a valid phone number.
POSITION DESCRIPTION
START DATE

MonthDayYear
Date
END DATE

MonthDayYear
Date
FINAL POSITION TITLE
FINAL SALARY
MAY WE CONTACT THIS EMPLOYER?

YESNO
EMPLOYER
LAST SUPERVICORS NAME
REASONFOR LEAVING
STREET ADDRESS CITY STATE, ZIP CODE
Phone Number
Please enter a valid phone number.
POSITION DESCAPTION
EDUCATION & TRAINING
COLLEGE UNIVERSITY OR TECHINCAL SCHOOL
Graduate?

YESNO
TYPE OF DEGREE OR DIPLOMA
MAJOR SUBJECT
NAME OF SCHOOL
CITY & STATE
COLLEGE UNIVERSITY OR TECHNICAL SCHOOL
GRADUATE?

YESNO
TYPE OF DEGREE OR DIPLOMA
MAJORSUBJECT
NAME OF SCHOOL
CITY & STATE
HIGH SCHOOL LAST ATTENDED
Graduate?*

YESNO
TYPE OF DEGREE OR DIPLOMA*
MAJOR SUBJECT*
NAME OF SCHOOL*
CITY & STATE*
OTHER
GRADUATE?

YESNO
TYPE OF DEGREE OR DIPLOMA
MAJOR SUBJECT
NAME OF SCHOOL
CITY & STATE
LIST SKILLS AND TRANNING YOU CONSIDER RELEVANT TO EMPLOYMENT AT BURT BROADCASTING INC*
LANCUAGE ADLITY LIST THOSE YOU COULD USE IN YOUR WORK
ENGLISH
Are you able too?*

SPEAKREADWRITE
OTHER
Are you able too?

SPEAKREADWRITE
OTHER
Are you able too?

SPEAKREADWRITE
REFERENCES
LIST THREE PERSONS OTHER THAN RELATIVES OR PERSONAL FRIENDS WHO HAVE KNOWLEDGE OF YOUR WORK EXPERIENCE AND/OR EDUCATION
Name/Title*

First & Last NameJob Title
Mailing Address*
Phone Number*
Please enter a valid phone number.
Name/Title

First & Last NameJob Title
Mailing address
Phone Number
Please enter a valid phone number.
Name/Title

First & Last NameJob Title
Mailing Address
Phone Number
Please enter a valid phone number.
AUTHORIZATION
APPLICATION MUST BE SIGNED PRIOR TO SUBMITTING
- hereby authorize investigation of all statements contained in this application and on my resume. if provided I certify that such statements are true, and understand that misrepresentation or omission of facts called for in this form or on any resume provided by me. is cause for termination of employment without notice
Signature*

Clear
Date*

MonthDayYear
Date
NO PERSON SHALL BE DENIED EMPLOYMENT ON THE BASE CF RACE, COLOR ETHNICITY NATIONAL ORIGIN SEXUGENCED SEXUAL ORIENTATION, RELIGION CREED, DISABILITY (INCLUDING HIV STATUS, AGE, VETERAN STATUS MARITAL STATUS OR X-ORTENDER STATUS),
Should be Empty:

EMPLOYMENT APPLICATION

DIRECTIONS:

GENERAL

POSITION

SALARY EXPECTED

EMPLOYMENT RECORD

EDUCATION & TRAINING

LANCUAGE ADLITY LIST THOSE YOU COULD USE IN YOUR WORK

REFERENCES

LIST THREE PERSONS OTHER THAN RELATIVES OR PERSONAL FRIENDS WHO HAVE KNOWLEDGE OF YOUR WORK EXPERIENCE AND/OR EDUCATION

AUTHORIZATION

APPLICATION MUST BE SIGNED PRIOR TO SUBMITTING

NO PERSON SHALL BE DENIED EMPLOYMENT ON THE BASE CF RACE, COLOR ETHNICITY NATIONAL ORIGIN SEXUGENCED SEXUAL ORIENTATION, RELIGION CREED, DISABILITY (INCLUDING HIV STATUS, AGE, VETERAN STATUS MARITAL STATUS OR X-ORTENDER STATUS),