Employment Form

Last Name:
 First Name:
 Middle Name:
Address:

 Apt #:

 City:
State:

 Zip:

 Phone Number:
Email:

Position(s) Applied For:
 Date of Application:
*MM/DD/YYYY
Date available for work
*MM/DD/YYYY

Are you a citizen of the United States? Y    N
Are you legally eligible to be employed in the United States? Y    N
Are you over the age of 18 years? Y    N
If no, you may be required to provide authorization to work.
 
Have you ever worked for this company? Y    N
If yes, when?
Job title:
 
Do you have any relatives/friends who have worked for Apr?s before? Y    N
If yes, who and where did they work?
 
Are you available to work: DAYS NIGHTS WEEKENDS FULL-TIME
If you cannot work full-time, please explain:

Days and Hours Available:
(If employed, I will notify my supervisor in writing, should my availability change).
DAY SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
From:
To:

Are you presently employed? Y    N
If yes, may we contact your employer? Y    N
If presently employed, why are you considering leaving? Y    N

Education
School or Institution Name and Location of School Course of Study # Year Degree Record
High School
College
Other

Have you completed any special courses, seminars and/or training that would enable you to perform the position for which you are applying? Y    N
If yes, please describe:

Previous Employment - List your last three (3) employers, beginning with the most recent
From *MM/DD/YYYY

 To *MM/DD/YYYY

 Company:
 Phone:
Job Title:

 Full Address:
Supervisor:
 May we contact your previous supervisor for a reference?
Y    N          If Not, why?
Job responsibilities
Reason for Leaving:

  

From *MM/DD/YYYY

 To *MM/DD/YYYY

 Company:
 Phone:
Job Title:

 Full Address:
Supervisor:
 May we contact your previous supervisor for a reference?
Y    N          If Not, why?
Job responsibilities
Reason for Leaving:

From *MM/DD/YYYY

 To *MM/DD/YYYY

 Company:
 Phone:
Job Title:

 Full Address:
Supervisor:
 May we contact your previous supervisor for a reference?
Y    N          If Not, why?
Job responsibilities
Reason for Leaving:


References
Please list three professional references.
Full Name Relationship Company Phone

APPLICANTS WILL RECEIVE CONSIDERATION FOR POSITIONS, WITHOUT REGARD TO RACE, COLOR, RELIGION, AGE, GENDER (EXCEPT WHERE GENDER IS A BONAFIDE OCCUPATIONAL QUALIFICATION), SEXUAL ORIENTATION, MARITAL STATUS, INDIVIDUALS WITH DISABILITIES, AND EQUALLY TO DISABLED VETERANS AND VETERANS OF THE VIETNAM ERA.


IMPORTANT, PLEASE READ AND SIGN:

I understand that failure to reveal any prior employer, or giving false or misleading information by me on any part of this Application for Employment can be grounds for termination from the company or its subsidiaries. I understand that if I am hired, my employment is for no definite time and may be terminated at any time without prior notice.


I agree to the above acknowledgment