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Employment Application Form

This document contains an employment application requesting information from applicants such as personal details, education history, work experience, skills, and references. It notes that the employer does not discriminate in hiring and makes decisions based on qualifications and merit. It also specifies that employment would be at-will.

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RJ Crafty Ink
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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420 views

Employment Application Form

This document contains an employment application requesting information from applicants such as personal details, education history, work experience, skills, and references. It notes that the employer does not discriminate in hiring and makes decisions based on qualifications and merit. It also specifies that employment would be at-will.

Uploaded by

RJ Crafty Ink
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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EMPLOYMENT APPLICATION

Please fill out the entire application.

EMPLOYER INFORMATION

Employer Name: _______________________________________________


Address: _____________________________________________________
City, State, and Zip Code: _______________________________________
Telephone: ____________________

___________________ is an Equal Opportunity Employer. We do not discriminate in our hiring


practices on the basis of race, religion, color, sex, gender, identity, sexual orientation, age,
disability, national origin, religion, veteran status, or any other status protected under federal,
state, or local law.

All employment decisions at ___________________ are decided on the basis of candidate


qualifications, merit, and the unique needs of our business and the position.

APPLICANT INFORMATION

Applicant Name: _______________________________________________


Address: _____________________________________________________
City, State, and Zip Code: _______________________________________
Telephone: ____________________ Alternate phone: _________________
Email Address: __________________________

Date of Application: ___________________

EMERGENCY CONTACT

Contact Name: ________________________________________________


Relationship to you: ____________________________________________
Address: _____________________________________________________
City, State, and Zip Code: _______________________________________
Telephone: ____________________ Alternate phone: _________________

EMPLOYMENT POSITION

Employment Position Applied For: __________________________________


Full or Part Time_____ Full time _____ Part time

When can you begin work if you are hired? __________________________


Salary Desired: $ ____________ per ____________

Did anyone refer you to our company? If yes, who: _________________________


Have you applied to any position at our company previously? _____ Yes _____ No
If yes, when did you apply: ________________________________________
If yes, what position did you apply for: _______________________________

Do you have any friends or family working at our company? _____ Yes _____ No
If yes, name: ________________________________________

How did you hear about this position? _____________________________________

WORK ELIGIBILITY

Are you at least 18 years old?______ Yes ______ No

If offered employment, are you able to provide proof that you are legally eligible to work in the
United States? _____ Yes _____ No

How you will get to work: _________________________________________

Driver's License (State/Number): ___________________________________

Are you able to perform the essential functions of the job position with or without reasonable
accommodation? _____ Yes _____ No

Are you willing to work any shift, including nights and weekends? _____ Yes _____ No
If no, please state any limitations: ________________________________________________

If applicable, are you available to work overtime? _____ Yes _____ No

EDUCATION AND TRAINING

Please list the schools attended.


Include any other pertinent information about your education and training.

School name: ___________________________________


Address: _____________________________________________________
From: __________ To: ___________ Did you graduate? _____ Yes _____ No
Subjects studied: ___________________________________

College/University: ___________________________________
Address: _____________________________________________________
From: __________ To: ___________ Did you graduate? _____ Yes _____ No
Degree received: ___________________________________

Other: ___________________________________
Address: _____________________________________________________
From: __________ To: ___________ Did you graduate? _____ Yes _____ No
Degree received: ___________________________________
Professional licenses, qualifications, or certifications:
____________________________________________________________

Special Achievements or Awards:


____________________________________________________________

EMPLOYMENT HISTORY

Please list all jobs. Begin with the current or most recent employment. For gaps in employment,
please include explanation. Continue on an extra sheet of paper if necessary.

Name of Employer: _____________________________________


Address: _____________________________________________________
From: __________ To: ____________ Position: _______________________
Key Duties: ___________________________________________________
Reason for Leaving: ____________________________________________
Supervisor Name: ____________________ Supervisor Phone: _____________________

Name of Employer: _____________________________________


Address: _____________________________________________________
From: __________ To: ____________ Position: _______________________
Key Duties: ___________________________________________________
Reason for Leaving: ____________________________________________
Supervisor Name: ____________________ Supervisor Phone: _____________________

Name of Employer: _____________________________________


Address: _____________________________________________________
From: __________ To: ____________ Position: _______________________
Key Duties: ___________________________________________________
Reason for Leaving: ____________________________________________
Supervisor Name: ____________________ Supervisor Phone: _____________________

Military Services? ______ Yes _____ No


Branch: ___________________________________________
Years of Service: From: __________ To: ____________
Specialized skills or training: ___________________________________________________
APPLICANT’S SKILLS

Skill: _____________________________________
Level: _____ Low _____ Medium _____ High

Skill: _____________________________________
Level: _____ Low _____ Medium _____ High

Skill: _____________________________________
Level: _____ Low _____ Medium _____ High

Language: _____________________________________
Level: _____ Fluent _____ Good _____ Fair

Language: _____________________________________
Level: _____ Fluent _____ Good _____ Fair

Other skills: __________________________________________________

REFERENCES

Name: _____________________________________
Relationship: ____________________
Address: _____________________________________________________
City, State, and Zip Code: ________________________________________
Telephone: _____________________

Name: _____________________________________
Relationship: ____________________
Address: _____________________________________________________
City, State, and Zip Code: ________________________________________
Telephone: _____________________

I certify that all statements given on this application are true and complete to the best of my
knowledge. I understand that any statements found to be false or misleading give sufficient
reason not to hire me, or if hired, can be grounds for immediate termination. I authorize
___________________ to conduct any investigation deemed appropriate concerning my
application.

I authorize former employers, references, and all other individuals and organizations disclosed
herein to provide any information sought in connection with this application.
The employment is at will, meaning that the employment is subject to termination at any time,
with or without cause or notice, and at any time. I acknowledge that no written or oral
representations nor representations about the employment can alter the at will employment
status, except those which are executed by representatives at ___________________ with the
express authority to do so.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND


AGREE TO ITS TERMS.

APPLICANT SIGNATURE__________________________ DATE _______________

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