Employment Application
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EMPLOYMENT APPLICATION
DATE ____________________
Mo
Day
Yr
EMPLOYER: _______________________________
APPLYING FOR __________________________________ POSITION
WORKSTUDY ELIGIBLE? YES NO
(Example: Cashier, Secretary, Maintenance
(circle yes or no)
PRINT CLEARLY
NAME_________________________________________________________________
______________________
Last
First
Middle
T Number
ADDRESS__________________________________________________________ (_____)______________________
Number
Street
Apt #
Phone Number
___________________________________________________________________ (_____)______________________
City
State
Zip Code
Alternate Phone
E-Mail ___________________________
Morning
Afternoon
Night
Weekends
EMPLOYMENT SOUGHT
: _______________________________________________________________________
HOURS AVAILABLE
(Example: M W F 10:00 to 2:00, Sat. 8:00 to 5:00, etc.)
_____________________________
DATE YOU CAN START
ARE YOU EMPLOYED NOW? YES NO IF SO, MAY WE CONTACT YOUR PRESENT EMPLOYER? YES NO
EDUCATION
College, Trade School
Major/Minor
Year in School
When will you
Name and City Location
Fr, Soph, Jr, Sr
graduate? Mo./Yr.
Southern Utah University
Cedar City, UT
QUALIFICATIONS AND SKILLS: Computer (software) programs, Tools, Equipment, Related skills, Certificates
(and any other traits that would make you a good employee) etc.
Continued on Other Side
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Parent category: Business