Standard Application for Employment

Standard Application for Employment
It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classifications. Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions on this application. You may attach a résumé, but all questions must be answered.
Position applying for*
PERSONAL DATA
Name (last, first, middle)*
Address*

Street Address and/or Mailing Address

Street Address Line 2

CityState

Zip
Date you can start work

MonthDayYear
Date
Cell Phone Number*
Format: (000) 000-0000.
POSITION INFORMATION Check all that you are willing to work*

DaysEveningsWeekends
Hours requesting to work*

Full TimePart Time
Are you authorized to work in the US on an unrestricted basis?*

YesNo
Have you ever been convicted of a felony?(Convictions will not necessarily disqualify an applicant for employment)*

YesNo
SPECIAL SKILLS List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.
SOCIAL MEDIA Add a social media account *

REFERENCES Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don’t have three professional references, then list personal, unrelated references.*

Rows	Name	Address/City/State	Phone	Relationship
Reference
Reference
Reference

WORK HISTORY Start with your present or most recent employment and work back.*

Rows	Company Name	Start Date	End Date	Supervisor's Name	Phone Number	Duties	Reason for Leaving
Job 1
Job 2
Job 3

May we contact your present employer?*

YesNoN/A
Should be Empty:

Standard Application for Employment

PERSONAL DATA