Desoto's Application for Employment

Name
Address
City
State
Zip
Phone Number
Mobile Number
Email Address
example@example.com
Are you a U.S. Citizen

YesNo
Have you ever been convicted of a felony?

YesNo
Position You Are Applying For
Available Start Date

MonthDayYear
Date
Desired Pay
Employment Desired

Full TimePart TimeSeasonal/Temporary
Shift Availability

Please enter your desired shift preferences
Days

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Lunch or Dinner

LunchDinner
Education
School Name 1
School 1 Location
School 1 Years Attended
School 1 Degree Received
School 1 Major
School Name 2
School 2 Location
School 2 Years Attended
School 2 Degree Received
School 2 Major
Reference 1 Name
Reference 1 Title
Reference 1 Company
Reference 1 Phone
Reference 2 Name
Reference 2 Title
Reference 2 Company
Reference 2 Phone
Employer 1
Job Title
Dates Employed

MonthDayYear
Date
Starting Pay Rate
Ending Pay Rate
Address

Address

Street Address Line 2

CityState

Zip
Phone
Employer 2
Job Title
Dates Employed

MonthDayYear
Date
Starting Pay Rate
Ending Pay Rate
Address

Address

Street Address Line 2

CityState

Zip
Phone
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, 1 understand that false or misleading information in my application or interview may r release.
Name Please Print
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

Shift Availability