Form Msec 1.1a - Application For Employment

ADVERTISEMENT

APPLICATION FOR EMPLOYMENT
An Equal Opportunity Employer
We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, genetic information or
any other status protected by law or regulation. It is our intention that all qualified applicants are given equal
opportunity and that selection decisions be based on job-related factors.
G
Answer each question fully and accurately. No action can be taken on this application until you have answered all questions. Use
blank paper if you do not have enough room on this application. PLEASE PRINT, except for signature on back of application. In
E
reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or
N
discrimination based upon non-job-related information.
E
Today’s Date _______________________
Job Applied for________________________________________________________
R
A
Are you seeking: Full-time
Part-time
Temporary
employment?
When could you start work? ________________
L
_______________________________________________________________________
_____________________
Last Name
First Name
Middle Name
Telephone Number
_______________________________________________________________________________________________
Present Street Address
City
State
Zip Code
Are you 18 years of age or older? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
(If you are hired, you may be required to submit proof of age.)
If hired, can you furnish proof you are eligible to work in the U.S.? ............................................................................ Yes
No
Have you ever applied here before?
Yes
No
If yes, when? _______________________________________
Were you ever employed here?
Yes
No
If yes, when? _______________________________________
Have you ever been convicted of any law violation?
Include any plea of “guilty” or “no contest.” (Exclude minor traffic violations.) . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, give details ___________________________________________________________________________________
(A conviction will not necessarily disqualify an applicant for employment.)
If employed, do you expect to be engaged in any additional business
or employment outside of our job? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, give details ___________________________________________________________________________________
For Driving Jobs Only: Do you have a valid driver’s license? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
Driver’s License Number _____________________________
Class of License ______
State Licensed In __________
Have you had your driver’s license suspended or revoked in the last 3 years? . . . . . . . . . . . . . . . . . . .
Yes
No
If yes, give details: _____________________________________________________________________________
List professional, trade, business or civic activities and offices held. (Exclude labor organizations and memberships which reveal race,
__________________________
color, religion, national origin, sex, age, disability, genetic information or other protected status.)
_______________________________________________________________________________________________
____________________________________________________________________________________________
Number of
Diploma/
E
Subjects
LIST NAME AND ADDRESS OF SCHOOLS
Years
Degree/
Studied
Completed
Certificate
D
High School or GED: ________________________________________________________________________________________
U
College or University: _______________________________________________________________________________________
C
A
Vocational or Technical: _____________________________________________________________________________________
T
What skills or additional training do you have that relate to the job for which you are applying?_______________________________
I
________________________________________________________________________________________________________
O
N
What machines or equipment can you operate that relate to the job for which you are applying? _____________________________
________________________________________________________________________________________________________
MSEC 1.1a (04/09)

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go
Page of 2