Application For Employment Form Page 2
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2DRIVER’S LICENSE (Only for positions which require driving)
Do you have a driver’s license?
Yes
No
Expiration date
Driver’s license
number
State of issue
Operator
Commercial (CDL)
Chauffeur
Have you had any accidents during the past three years?
Yes
No
How many?
Have you had any moving violations during the past three years
Yes
No
How many?
MILITARY
Are you a veteran of the United States military service?
Yes
No If yes, what branch?
If yes, Date Entered
Date Discharged
If yes, please describe any special skills or training acquired while in the service:
WORK EXPERIENCE
Please list your work experience beginning with your most recent job. If you were self-employed, give firm name. Attach additional
sheets if necessary.
Most Recent Employer
Dates Employed
Work Performed
From:
To:
Address
Supervisor
Job Title
Reason for Leaving
Employer
Dates Employed
Work Performed
From:
To:
Address
Supervisor
Job Title
Reason for Leaving
REFERENCES
Please list two references other than relatives or previous employers.
Name
Name
Position
Position
Company
Company
Address
Address
Telephone (
)
Telephone (
)
I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am
employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make
any investigations of my prior educational and employment history.
I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship
at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis.
Signature of applicant
Date
FOR OFFICE USE ONLY
Date of Board Approval as:
F/T Employee ____________________
Substitute _______________________
12/2014
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Parent category: Business