Employment Application Employment Application PERSONAL INFORMATION SOCIAL SECURITY NUMBER APPLICATION DATE REFERRED BY LAST NAME FIRST NAME MIDDLE INITIAL TELEPHONE NUMBER PRESENT ADDRESS CITY STATE ZIP ARE YOU LESS THAN 18 YEARS OF AGEYesNo UPON OFFER OF EMPLOYMENT, VERIFCATION OF YOUR LEGAL RIGHT TO WORK IN THE UNITED STATES WILL BE REQUIRED. HAVE YOU EVER USED ANOTHER NAME?YesNo DRIVERS LICENSE NUMBER STATE EXPIRATION DATE DRIVING RECORDS Have you been convicted of a crime? (Convictions will not necessarily disqualify an applicant from employment. Do not provide information about misdemeanor marijuana convictions more than two years old or convictions that have been judicially dismissed, expunged or ordered sealed pursuant to law.YesNo IF "YES" PLEASE EXPLAIN: EMPLOYMENT DESIRED DATE AVAILABLE WAGE DESIRED POSITION DESIRED OR AREA OF INTEREST HAVE YOU EVER APPLIED TO THIS ORGANIZATION BEFOREYesNo IF YES, GIVE DATE/POSITION APPLIED FOR HAVE YOU EVER BEEN EMPLOYED BY OUR ORGANIZATION BEFOREYesNo IF YES, GIVE DATES OF EMPLOYMENT NAMES OF FRIENDS OR RELATIVES EMPLOYED BY THIS ORGANIZATION ARE YOU ABLE TO PERFORM THE ESSENTIAL FUNCTIONS OF THE JOB FOR WHICH YOU ARE APPLYING WITH OR WITHOUT REASONABLE ACCOMMODATION? YesNo CAN YOU WORK OVERTIME?YesNo ARE YOU CURRENTLY EMPLOYED?YesNo IF SO, MAY WE CONTACT YOUR PRESENT EMPLOYER?YesNo COMMENTS EDUCATION/U.S. MILITARY SERVICE PLEASE INDICATE ANY LANGUAGES, OTHER THAN ENGLISH THAT YOU: SPEAK READ WRITE SCHOOL LEVEL NAME AND LOCATION OF SCHOOL MAJOR UNIT COMPLETED ANDGRADE AVERAGE DEGREES AND/OR DIPLOMAS HIGH SCHOOL MAJOR UNIT COMPLETED ANDGRADE AVERAGE DEGREES AND/OR DIPLOMAS COLLEGE MAJOR UNIT COMPLETED ANDGRADE AVERAGE DEGREES AND/OR DIPLOMAS COLLEGE MAJOR UNIT COMPLETED ANDGRADE AVERAGE DEGREES AND/OR DIPLOMAS OTHER MAJOR UNIT COMPLETED ANDGRADE AVERAGE DEGREES AND/OR DIPLOMAS PROFESSIONAL CERTIFICATE OR LICENCES HELD ARE YOU PRESENTLY TAKING ANY EDUCATIONAL COURSE?YesNo IF YES, WHAT AND WHERE HAVE YOU EVER SERVED IN THE U.S. ARMED SERVICES?YesNo IF YES, MILITARY DUTIES AND TRAINING REFERENCES PLEASE LIST THREE NON-RELATIVES WHO ARE QUALIFED TO EVALUATE YOUR CAPABILITIES NAME AND ADDRESS TELEPHONE OCCUPATION YEARS KNOWN NAME AND ADDRESS TELEPHONE OCCUPATION YEARS KNOWN NAME AND ADDRESS TELEPHONE OCCUPATION YEARS KNOWN NAME AND ADDRESS TELEPHONE OCCUPATION YEARS KNOWN EMERGENCY INFORMATION IN CASE OF EMERGENCY, NOTIFY NAME TELEPHONE ADDRESS CITY STATE ZIP EMPLOYMENT HISTORY GIVE EMPLOYMENT RECORDS AS COMPLETELY AS POSSIBLY. LISTING MOST RECENT EMPLOYMENT FIRST, INCLUDE EMPLOYED/SELF-EMPLOYED PERIODS AND PART-TIME OR SUMMER WORK COMPANY NAME AND LOCATION TELEPHONE POSITIONS HELD TYPE OF BUSINESS RATE OF PAY (HR/WK/MO)FROMEND DATES EMPLOYEDFROMEND NAME OF SUPERVISOR REASON FOR LEAVING DESCRIPTION OF DUTIES COMPANY NAME AND LOCATION TELEPHONE POSITIONS HELD TYPE OF BUSINESS RATE OF PAY (HR/WK/MO)FROMEND DATES EMPLOYEDFROMEND NAME OF SUPERVISOR REASON FOR LEAVING DESCRIPTION OF DUTIES COMPANY NAME AND LOCATION TELEPHONE POSITIONS HELD TYPE OF BUSINESS RATE OF PAY (HR/WK/MO)FROMEND DATES EMPLOYEDFROMEND NAME OF SUPERVISOR REASON FOR LEAVING DESCRIPTION OF DUTIES COMPANY NAME AND LOCATION TELEPHONE POSITIONS HELD TYPE OF BUSINESS RATE OF PAY (HR/WK/MO)FROMEND DATES EMPLOYEDFROMEND NAME OF SUPERVISOR REASON FOR LEAVING DESCRIPTION OF DUTIES APPLICANT'S SIGNATURE: DATE: Call Us 520-797-5656 Website Design by Wilcat SEO RoofSmart LLC, Quality Roofing . . . Affordable Pricing Get Started
