Application For Employment

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APPLICATION FOR EMPLOYMENT
DATE:__________________
POSITION APPLIED FOR:___________________________________
Referred by:____________________________ Date Available for Work:_______________________
INSTRUCTIONS:
Please read carefully. Every item on this form must be answered to the best of your ability. Please print and use a
pen. Your qualifications will be carefully reviewed, and you will be given thorough consideration for any suitable vacancy. Upon employment,
this application will become part of your permanent record with this institution. Keep this in mind as you complete it. Special Note: You are
not required to supply any information that is prohibited by Federal, State or Local Law. We are an Equal Opportunity Employer. You may
request assistance to complete this application.
__________________________________________________________________________________________________________
PERSONAL
Name_________________________________________
Telephone Number ____________________
First
M.I.
Last
Street__________________________________ City__________________State_____ Zip__________
Previous Address__________________________________ Social Security Number________________
D.O.B._________________ Age________ Height____________
Sex__________
Are you legally entitled to work in the United States? ______Yes _____ No
Have you ever been convicted of a felony? _______ If yes, explain:________________________________
Have your driving privileges ever been revoked or suspended? ______Yes ______ No
__________________________________________________________________________________
EDUCATION
High School (Name and Address)__________________________________________________________
Did you graduate?_______ If no, last grade completed______ G.E.D. Obtained?_____________________
Colleges (Name and Address)_____________________________________________________________
Colleges (Name and Address)_____________________________________________________________
Did you graduate?______ If no, number of hours completed__________
Degree____________________
__________________________________________________________________________________
MILITARY
List service in U.S. Military-From___________________ to _________________ Branch_____________
Rank at Discharge______________ Military experience that may be applicable_______________________
__________________________________________________________________________________
GENERAL EMPLOYMENT INFORMATION
1. List all of the equipment with which you have had experience and training. Examples: typewriter, adding
machine, computers, calculators, etc._____________________________________________________
2. List any licensing that you may have, such as CDL____________________________________________
3. Were you previously employed by this institution?_______ If yes, when_____________to ___________
4. Salary Expected__________ hour________week Number of hours you are available per week_________

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