GHTC | Employment Application

City for which you are applying for work
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Position
Describe Other
Wage Desired
Date you can start

MonthDayYear
Attending School?
Where?
Days/Hours attending
Days and Hours Available

(please consider school, extra-curricular activities, and other obligations when filling out this section)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Can you work weekends/holidays?
If No, explain
Are you currently employed?
Where?
Last two employers
Employer
Rate
Phone Number

Area CodePhone Number
From
To
Reason for Leaving
Employer
Rate
Phone Number

Area CodePhone Number
From
To
Reason for Leaving
Should be Empty: