Mills James Employment Application

EMPLOYMENT APPLICATION
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone number *
E-mail *
Are you a U.S. citizen?

Yes No

EDUCATION
High School
Name of High School attended
Graduated?

Yes
College
Name of College/University attended
Highest grade completed?
Graduated?

Yes
Area of Study/Degree
Graduate School
Name of Graduate School attended
Highest grade completed?
Graduated?

Yes
Area of study/degree
Trade/Technical/Other school
Name of Trade/Technical/Other school attended
Highest grade completed?
Graduated?

Yes
Area of study/degree

CURRENT EMPLOYMENT
Current Employer *
Name of current employer or NONE if not employed
Position
Start Date

Month Day Year
Salary *
Address

Street Address

Street Address Line 2

City State

Zip Code
Reason for leaving?
May we contact your current employer?

Yes No
Supervisor

First Name Last Name
Phone number *

PREVIOUS EMPLOYMENT

List your employers or military service in chronological order, beginning with your most recent employer.
Previous Employer
Name of previous employer
Position
Address

Street Address

Street Address Line 2

City State

Zip Code
Salary
Reason for Leaving?
Supervisor

First Name Last Name
Start Date

Month Day Year
End Date

Month Day Year
Previous Employer
Name of previous employer
Position
Address

Street Address

Street Address Line 2

City State

Zip Code
Salary
Reason for Leaving?
Supervisor

First Name Last Name
Start Date

Month Day Year
End Date

Month Day Year

REFERENCES

Please list three references other than relatives. These are individuals who can provide a professional reference including previous employers, managers, colleagues, clients, business contacts, and others who can recommend you for the position.
Reference 1 *

First Name Last Name
Relationship *
Years acquainted *
Company
Position
Phone Number *
E-mail *
Reference 2 *

First Name Last Name
Relationship *
Years acquainted *
Company
Position
Phone Number *
E-mail *
Reference 3 *

First Name Last Name
Relationship *
Years acquainted *
Company
Position
Phone Number *
E-mail *

RESUME & PORTFOLIO
Cover Letter
Resume *
Portfolio
Portfolio website
LinkedIn profile

SUBMIT APPLICATION
By signing this application, I certify that all of the foregoing information is a complete and accurate statement of the facts, and understand that if any misrepresentation, omission or falsification be discovered, it will constitute grounds for dismissal.

I hereby authorize you to conduct any investigation necessary concerning any part of my background related to the position I am seeking, and understand that employment may be contingent upon the results of a drug screen.

I release all parties from any liability in connection with the provision and use of such information. I understand and agree that, if employed by this organization, I will abide by its rules and regulations, which I understand are subject to change. I further understand that, if hired, my employment is “at will” and may be terminated by either party at any time, with or without cause.

Mills James provides equal employment opportunity to all qualified individuals without regard to their race, color, religion, national origin, age, sex, disability, military status, citizenship or any other legally protected status in accordance with applicable local, state and federal law. EOE.
I have read and agree with the above applicant's statement. *

Yes
Date *

Month Day Year
Signature *

Sign your full name. Clear
Please verify that you are human *
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