Employment Application

Employment Application
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

Education
Name of High School*
High School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
High School Start Date

MonthDayYear
Date
High School End Date

MonthDayYear
Date
Do you have a High School Diploma or GED?*

YesNo
Do you have any college credits?*

YesNo

Education
Name of College/University
College/University Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College/University Start Date

MonthDayYear
Date
College/University End Date

MonthDayYear
Date
Did you graduate?

YesNo
What was your degree?
Do you have any other schooling?*

YesNo

Other Schooling
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Did you graduate?

YesNo
Degree

Professional Reference
Reference Name

First NameLast Name
Reference Phone Number
Please enter a valid phone number.
Company where reference works
Relationship to you
How long have you known your professional reference?

Personal Reference
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
How long have you known your personal reference?
Do you have previous employment?*

YesNo

Recent Previous Company
Recent Previous Company
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Started

MonthDayYear
Date
Date Ended

MonthDayYear
Date
Your Job Title While Employed
Responsibilities
Reason for leaving
Supervisor Name

First NameLast Name
May we contact your supervisor for a reference?

YesNo
Do you have a second previous employment?*

YesNo

2nd Previous Company
2nd Previous Company
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Started

MonthDayYear
Date
Date Ended

MonthDayYear
Date
Your Job Title While Employed
Responsibilities
Reason for Leaving
Supervisor Name

First NameLast Name
May we contact your previous supervisor for a reference?

YesNo
Do you have a third previous employment?*

YesNo

3rd Previous Company
3rd Previous Company
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Started

MonthDayYear
Date
Date Ended

MonthDayYear
Date
Your Job Title While Employed
Responsibilities
Reason for Leaving
Supervisor Name

First NameLast Name
May we contact your previous supervisor for a reference?

YesNo

Do you have any military service?*

YesNo

Military Service
Branch
Date Started

MonthDayYear
Date
Date Ended

MonthDayYear
Date
Rank at Discharge
Type of Discharge
If other than honorable, explain.

Work Schedule (Part 2) & Signature
List below the names of classes you are presently taking and days/times of the class:
I would like to work approximately this many hours per week:*
Check the areas you would like to work

Northern Carroll County (Ebb Valley Elementary, Manchester Elementary, Hampstead Elementary, North Carroll Community School)Central Carroll County (Elmer Wolfe Elementary, Friendship Valley Elementary, St. John School, Westminster Elementary)Southeastern Carroll County/Baltimore County (Eldersburg Elementary, Mechanicsville Elementary, Piney Ridge Elementary, Sacred Heart School)Southwestern Carroll County (Parr's Ridge Elementary, Winfield Elementary)Eldersburg Summer Camp (held at Piney Run Park in Sykesville)Deer Park Summer Camp (held at Deer Park UMC in Westminster)
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: