Employment Application Form Page 2
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1
2AVAILABILITY
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
From:
From:
From:
From:
From:
From:
From:
To:
To:
To:
To:
To:
To:
To:
If hired, when could you begin work?
How many hours would you like each week?
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□
Are you available on holidays?
Yes
No
EDUCATION
Name
City, State
# of Years Completed
Degree (Y/N and type)
High School
College
Other
Please list all job related organizations, clubs or activities you are/were involved in at school, except those that indicate race, religion, color,
national origin, ancestry, sex or age.
WORK EXPERIENCE
Dates of Employment & Ending
Company Name & Location
Position & Reason for Leaving
Supervisor Name & Phone #
Wage/Salary
A
C
DDITIONAL
OMMENTS
I certify that I have read and understand the applicant instructions included with this application and that the answers
given by me to the foregoing questions and statements made by me are complete and true to the best of my knowledge
and belief.
I understand that any false information, omissions or misrepresentations of facts called for in this application, whether on
this document or not, may result in rejection of my application or discharge at any time during my employment.
I understand that this application form is intended for use in evaluating my qualifications for employment and that this
application is not an offer of employment. I further understand that if hired, my employment will be considered "at-will" and
that my employment may be terminated for any reason, with or without cause or notice, at any time by me or the
Company and that this application is not intended to constitute a contract of continued employment.
Applicant Signature:
Date:
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