The Harper Company Employment Application

Employment Application
Thank you for your interest in applying for a position with our Company! We want to have a complete understanding of your qualifications and interests, so we can make careful and deliberate hiring decisions that will benefit the Company, you, and all of our employees. Please answer the questions honestly and completely.

We are an equal employment opportunity employer. All applicants are considered for employment based upon their qualifications, without regards to race, color, religion, sexual orientation, gender identity, national origin, sex, age, maritalstatus or disability. This statement is also intended to adhere to the Rehabilitation Act, Vietnam Era Veterans’ ReadjustmentAssistance Act, Americans with Disabilities Act and The Civil Rights Act.

The Harper Company is a UNION Contractor and we contact the local union halls for employee referrals to meet ouremployment demands. If you are a Union Member, be sure they know you are available for work. If you are not a Union Member, you will be expected to join within seven working days.
Applicant Information
Name*

First NameMiddle InitialLast Name
Date*

MonthDayYear
Date
Address*

Street Address

Apt/Unit #

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Position applied for:*
Date Available:*

MonthDayYear
Date
Last 4 digits of social security number:
Are you authorized to work in the US?*

YesNo
Have you ever worked for this company?*

YesNo
If yes, when?
If yes, who was your supervisor?

Education
High School:*
High School Address:*
Years attended:
First: Date*
Last: Date*
Did you graduate?*

YesNo
Diploma:
College:
Address:
First year attended: Date
Last year attended: Date
Did you graduate?

YesNo
Degree:
Other Education:
Address:
First year attended: Date
Last year attended: Date
Did you graduate?

YesNo
Degree:

Previous Employment
Company
Phone Number
Please enter a valid phone number.
Address:
Supervisor:
Job Title:
From: Date
To: Date
Responsibilities:
May we contact your previous supervisor for a reference?

YesNo
Company:
Phone Number:
Please enter a valid phone number.
Address:
Supervisor:
Job Title:
From: Date
To: Date
Responsibilities:
May we contact your previous supervisor for a reference?

YesNo
Company:
Phone Number:
Please enter a valid phone number.
Address:
Supervisor:
Job Title:
From: Date
To: Date
Responsibilities:
May we contact your supervisor for a reference?

YesNo

Military Service
Branch:
From:
To:
Rank at discharge:
Type of discharge:
If other than honorable, explain:

References

Please list three professional references. (This section is optional, but preferred)
Reference #1
Full name:   First Name   Last Name
Company:
Relationship:
Phone:   Area Code   Phone Number
Address:
Email:
Reference #2
Full name:   First Name   Last Name
Company:
Relationship:
Phone:   Area Code   Phone Number
Address:
Email:
Reference #3
Full name:   First Name   Last Name
Company:
Relationship:
Phone:   Area Code   Phone Number
Address:
Email:

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:

Employment Application

Applicant Information

Education

Previous Employment

Military Service

Skills & Miscellaneous

References

Disclaimer and signature