Rowan-Kannapolis ABC Board Application

Employment Application
GENERAL INFORMATION
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.

Please answer the questions below.

Rows	Yes	No
Are you related to any employee of the ABC Board?
Have you ever worked for a NC ABC Board?
Have you ever been convicted of a felony?

If you answered "Yes" to any of the above questions, please provide an explanation below:

Please answer the questions below.

Rows	Yes	No
Are you 21 year of age or older?
Are you legally authorized to work in the United States?

POSITION INFORMATION
What position are you applying for?
Desired Salary:
Hours Desired:
What is your current employment status?
AVAILABILITY

Operating hours are 9:00 AM to 9:00 PM.

Rows	All Day (9:00am-9:00pm)	9:00am - 2:30pm	2:30pm - 9:00pm	Other*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Available start date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
*If you selected "other", please provide your availability below:

EDUCATION

Please provide the information requested below.

Rows	School Name & Location	Number of Years Completed	Diploma, Degree, or Certificate Received	Course of Study or Major
High School or Equivalent
College or University
Graduate School
Vocational, Trade, or Other School

EMPLOYMENT HISTORY
Current or most recent Employer:
Company Name
Dates of Employment:
From: To:
Address:

Street Address

Street Address Line 2

CityState / Province
Job Title:
Job Duties:
Name of Supervisor:
Reason for Leaving:
Previous Employer:
Company Name
Dates of Employment:
From: To:
Address:

Street Address

Street Address Line 2

CityState / Province
Job Title:
Job Duties:
Name of Supervisor:
Reason for Leaving:
Previous Employer:
Company Name
Dates of Employment:
From: To:
Address:

Street Address

Street Address Line 2

CityState / Province
Job Title:
Job Duties:
Name of Supervisor:
Reason for Leaving:
MILITARY SERVICE
Have you served in the Military?
Branch:
Total Years of Service:
Rank at Discharge:
Type of Discharge:
If other than honorable, please explain:

REFERENCES

Please provide three (3) personal or professional references who are not relatives or former employers.

Rows	Name	Relationship	Length of time known	Phone #
1.
2.
3.

Are you submitting a résumé with this application?
Please upload your resume below:

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