Job Applicant Questionnaire And Agreement Template printable pdf download

This Company is an equal opportunity employer. In all our employment practices, including hiring, we are firmly committed to equal

opportunity without regard to race, religion, color, sex, age, national origin, citizenship, disability or any other basis of discrimination

prohibited by applicable local, state or federal law. No question on this application is used for the purpose of limiting or excluding

any applicant's consideration for employment on such grounds.

____________________________________________________________________________

ANSWER ALL QUESTIONS. INCOMPLETE APPLICATIONS WILL BE REJECTED

Name: _______________________________________ Street Address: _____________________________________________

Last

First

Apt #

Zip ___________ Email _________________________

Or Box ________ City ______________________ State ______

Telephone ( __ __ __ ) __ __ __ - __ __ __ __

18 or older? [ ] Yes [ ] No If not, Birth Date: _______________

____________________________________________________________________________



Did any employer, school or reference know you by another name? [ ] Yes [ ] No



If Yes, indicate other name: _______________________________________________________________



Position for which you are applying: ______________________________________________________



What wage/salary do you expect? $_________________ per __________________



If hired, when could you start work? _____________________________________________________



Who referred you to this company for employment? __________________________________________



Names of friends or relatives working for the Company (list name(s) and relationship):

_____________________________________________________________________________________

AVAILABILITY:

How many hours per week are you available for work? ________ (LIST TIMES BELOW)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

FROM

CERTAIN POSITIONS WITHIN THE COMPANY REQUIRE USE OF A CAR OR OTHER MOTORIZED VEHICLE. IF USE OF

SUCH A VEHICLE WERE REQUIRED IN THE JOB FOR WHICH YOU ARE APPLYING.......



Do you have a valid Driver’s License? [ ] Yes [ ] No

If No, can you obtain one? [ ] Yes [ ] No



Do you have access to a car or other motorized vehicle? [ ] Yes [ ] No



Do you or can you get liability insurance on such a vehicle? [ ] Yes [ ] No

YOUR DRIVING RECORD WILL BE CHECKED IF YOU DRIVE A COMPANY VEHICLE.

EDUCATION:

High School _________________________________________ Address ___________________________________

City ___________________________ State _______ Zip ______________ Last grade completed _______________

Grade Point Avg: _______________ Did you graduate? [ ] Yes [ ] No

Still Enrolled? [ ] Yes [ ] No

-----------------------------------------------------------------------------

Trade or College _____________________________________ Address ____________________________________

City __________________________ State ________ Zip ______________ Last grade completed _______________

Course/Major ______________________________ Degree(s) or Certification(s) ______________________________

Grade Point Avg: _______________ Did you graduate? [ ] Yes [ ] No

Still Enrolled? [ ] Yes [ ] No

Job Applicant Questionnaire And Agreement Template

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