Employment Application — Habegger Furniture

Employment Application — Habegger Furniture
We consider applications for all positions without regard to race, color, religion, creed, sex, national origin, disability, sexual orientation, citizenship status or any other legally protected status. WE ARE AN EQUAL OPPORTUNITY EMPLOYER.
Position(s) Applied For
Date of Application

MonthDayYear
Date
How Did You Learn About Us?

Other
If Other, please specify
Personal Information
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Telephone Number(s)
Please enter a valid phone number.Format: (000) 000-0000.
Social Security Number (Voluntary)
Best Time to Contact You at Home

Hour Minutes

AM/PM Option

until
until
Hour Minutes

AM/PM Option
Eligibility
If you are under 18, can you provide proof of eligibility to work?
Have you ever filed an application with us before?
If yes, date of previous application
Have you ever been employed with us before?
If yes, date of previous employment
Do any friends or relatives (other than spouse) work here?
Are you currently employed?
May we contact your present employer?
Are you prevented from working in this country due to Visa or Immigration Status?
Availability
Date Available for Work

MonthDayYear
Date
Desired Salary Range
Available to Work
Are you currently on "lay-off" status and subject to recall?
Can you travel if a job requires it?
Have you been convicted of a felony in the last 5 years?
Education

Education History

Rows	Name & Address of School	Course of Study	Years Completed	Diploma/Degree
Elementary School
High School
Undergraduate College
Graduate/Professional
Other

Describe any specialized training, apprenticeships, skills, and extra-curricular activities
Describe any job-related training received in the U.S. Military
Employment Experience
Start with your present or last job. Include job-related military service and volunteer activities.
Employer 1
Employer Name
Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employer Phone
Please enter a valid phone number.Format: (000) 000-0000.
Dates Employed - From

MonthDayYear
Date
Dates Employed - To

MonthDayYear
Date
Job Title
Supervisor
Starting Pay
Final Pay
Reason for Leaving
Work Performed
Divider
Employer 2
Employer Name
Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employer Phone
Please enter a valid phone number.Format: (000) 000-0000.
Dates Employed - From

MonthDayYear
Date
Dates Employed - To

MonthDayYear
Date
Job Title
Supervisor
Starting Pay
Final Pay
Reason for Leaving
Work Performed
Divider
Employer 3
Employer Name
Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employer Phone
Please enter a valid phone number.Format: (000) 000-0000.
Dates Employed - From

MonthDayYear
Date
Dates Employed - To

MonthDayYear
Date
Job Title
Supervisor
Starting Pay
Final Pay
Reason for Leaving
Work Performed
Divider
Employer 4
Employer Name
Employer Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Employer Phone
Please enter a valid phone number.Format: (000) 000-0000.
Dates Employed - From

MonthDayYear
Date
Dates Employed - To

MonthDayYear
Date
Job Title
Supervisor
Starting Pay
Final Pay
Reason for Leaving
Work Performed
Additional Information
Other Qualifications - Summarize special job-related skills and qualifications acquired from employment or other experience.
Specialized skills
Other skills/equipment
Additional information helpful to your application
Can you perform the essential job functions with or without reasonable accommodation?
References
Please do not list relatives.
Reference 1 Name

First NameMiddle NameLast Name
Reference 1 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 1 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 2 Name

First NameMiddle NameLast Name
Reference 2 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 3 Name

First NameMiddle NameLast Name
Reference 3 Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Applicant’s Statement
I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Signature
Date

MonthDayYear
Date
Should be Empty:

Employment Application — Habegger Furniture

Personal Information

Eligibility

Availability

Education

Employment Experience

Additional Information

References

Applicant’s Statement