Sample Employment Application Form
PLEASE PRINT ALL
INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS
PLEASE COMPLETE PAGES 1-4.
DATE ________________________________
Name ______________________________________________________________________________________________
Last
First
Middle
Maiden
Present address ______________________________________________________________________________________
Number
Street
City
State
Zip
How long ____________________
Social Security No. _______ – _____ – _________
Telephone ( )
If under 18, please list age _____________________
Position applied for (1) ________________________
and salary desired (2) ________________________
(Be specific)
Days/hours available to work
No Pref _______ Thur ________
Mon __________ Fri __________
Tue __________ Sat _________
Wed _________ Sun ________
How many hours can you work weekly? _________________________ Can you work nights? _______________________
Employment desired
__ FULL-TIME ONLY
__ PART-TIME ONLY
__ FULL- OR PART-TIME
When available for work?_______________
____________________________________________________________________________________________________
TYPE OF SCHOOL
NAME OF SCHOOL
LOCATION
(Complete mailing
address)
NUMBER OF YEARS
COMPLETED
MAJOR &
DEGREE
High School
College
Bus. or Trade School
Professional School
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
__ No
__ Yes
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were
committed, sentence(s) imposed, and type(s) of rehabilitation. __________________________________________________
____________________________________________________________________________________________________
PLEASE PRINT ALL
INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
DO YOU HAVE A DRIVER’S LICENSE?
__ Yes __ No
What is your means of transportation to work? ________________________________________________