SAVAGE SMASH JOB APPLICATION

SAVAGE SMASH JOB APPLICATION
NAME Last, first, middle
ADDRESS Number, street, city, zip-code
Are you at least 18 years old?
Referred By:
Position/Job Applying For:
Date you can start:

MonthDayYear
Date
Salary/Hourly wage expected:
How many hours per week are you interested in working?
What days are you available to work?

Monday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PMSunday AMSunday PM
Are you a member of any organization, club, group, team, fellowship?
If yes, please list
Previous Employer #1 Name
Dates Employed:
From - To
Address
Pay Rate Start
Last Pay Rate
Name of Supervisor
Telephone
Job Held and Responsibilities
Reason for Leaving
Previous Employer #2 Name
Dates Employed:
From - To
Address
Pay Rate Start
Last Pay Rate
Name of Supervisor
Telephone
Job Held and Responsibilities
Reason for Leaving
Previous Employer #3 Name
Dates Employed
From - To
Address
Pay Rate Start
Last Pay Rate
Name of Supervisor
Telephone
Job Held and Responsibilities
Reason for Leaving
I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired.
References, Please give the names of at least two persons not related to you whom may have known you for at least one year
Name
Address
Business
Phone
Yrs Acquainted
Name
Address
Business
Phone
Yrs Acquainted
Name
Address
Business
Phone
Yrs Acquainted
In case of emergency, please notify:
Address
Phone
THE INFORMATION PROVIDED IN THIS APPLICATION FOR EMPLOYEMENT IS TRUE, CORRECT AND COMPLETE. IF EMPLOYED, ANY MISSTATEMENTS OR OMISSION OF FACTS ON THIS DOCUMENT MAY RESULT IN MY DISSMISAL. I UNDERSTAND THAT ACCEPTANCE OF EMPLOYMENT DOES NOT CREATE A CONTRACTUAL OBLIGATION UPON THE EMPLOYER TO CONTINUE TO EMPLOY ME IN THE FUTURE.I CERTIFY THAT I AM PHYSICALLY ABLE TO PERFORM THE DUTIES OF THE JOB FOR WHICH I AM APPLYING. I AUTHORIZE YOU TO CONDUCT AN INVESTIGATION ON MY CREDIT AND PERSONAL HISTORY. IF A REPORT IS OBTAINED, YOU MUST PROVIDE AT MY REQUEST, THE NAME OF THE AGENCY SO I MAY REVIEW THE NATURE AND SUBSTANCE OF THE INFORMATION IN THE REPORT.
DATE

MonthDayYear
Date
APPLICANT NAME
Email
example@example.com
Phone Number
Please enter a valid phone number.
SIGNATURE

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