High School United States

Application For Employment

We Are An Equal Opportunity Employer

Please Print

Last Name First Name Middle Initial Social Security Number Address City Zip Code Phone Number

WORK EXPERIENCE - LIST MOST RECENT JOB FIRST

From Employer's Name/Address/Telephone Start Pay Job Title To Last Pay Reason for Leaving

Describe the Work You Did

From Employer's Name/Address/Telephone Start Pay Job Title To Last Pay Reason for Leaving

Describe the Work You Did

From Employer's Name/Address/Telephone Start Pay Job Title To Last Pay Reason for Leaving

Describe the Work You Did

GENERAL INFORMATION

What position are you applying for? Full Time? [ ] Part Time? [ ] When are you available to start work? Are you willing to work overtime? Yes [ ] No [ ] Are you at least 18 years old? Yes [ ] No [ ]

If not, can you provide a valid Work Permit, high school diploma, or equivalent? Yes [ ] No [ ] What languages do you speak, read, or write fluently? If hired, can you verify that you have the legal right to work in the United States? Yes [ ] No [ ] Do you have any special skills, training, or experience which may help you qualify for this job? Yes [ ] No [ ] If so, please explain

Do you have a reliable means of transportation to get to work? Yes [ ] No [ ] Are there any times during the week that you are not available to work? Yes [ ] No [ ] If so, please explain

Do any of your relatives work for this company? Yes [ ] No [ ] If so, who? Have you ever worked for this company before? Yes [ ] No [ ] If so, when? Have you ever been convicted of a crime, excluding misdemeanors and summary offenses? Yes [ ] No [ ] (NOTE:Conviction will not necessarily disqualify applicant) If so, please explain

How did you find out about this job?

CERTIFICATION AND ACKNOWLEDGMENT

I certify that the information provided herein is true and correct to the best of my knowledge. I understand that, if employed, falsified statements on this Application for Employment form will be considered grounds for termination. I authorize the company to thoroughly investigate my work experience and any other matters related to my suitability for employment. I further authorize my former employers to disclose to the company any and all information they may have concerning my previous employment. in addition, I hereby release the company, my former employers, and all other persons from any and all claims, demands, or liabilities arising out of, or in any way related to, such disclosure. I acknowledge that, if employed, both the company and I have the right to terminate the employment relationship at any time, with or without cause or advance notice. This employment at will relationship will remain in effect throughout my employment with the company and may not be modified by any oral or implied agreement. Applicant's Signature Date

Solicitud Para Empleo

Somos Jefes que Ofrecen Oportunidad Igual

Letra de Molde

Apellido Primer Nombre Inicial No. De Seguro Social Direccion Ciudad Zona Postal No. De Telefono

EXPERIENCIA DE TRABAJO - ESCRIBA EL EMPLEO MAS RECIENTE PRIMERO Desde Nombre del Jefe/Direccion/Telefono Pago Inicial Titulo del Trabajo Hasta Pago Final Razon de Salida

Descripcion de Tareas

Desde Nombre del Jefe/Direccion/Telefono Pago Inicial Titulo del Trabajo Hasta Pago Final Razon de Salida

Descripcion de Tareas

Desde Nombre del Jefe/Direccion/Telefono Pago Inicial Titulo del Trabajo Hasta Pago Final Razon de Salida

Descripcion de Tareas

INFORMACION GENERAL

Que posicion esta solicitando? Tiempo Completo? [ ] Medio-Tiempo? [ ] En que fecha esta disponible para empezar? Puede trabajar tiempo extra? Si [ ] No [ ] Tiene por lo menos 18 anos? Si [ ] No [ ]

Si No, puedo proveer un Permiso de Trabajo valido, diploma de secundaria, o algo equivalente? Si [ ] No [ ] Que idiomas puede hablar, leer o escribir con facilidad? Si lo emplean, puede verificar que tiene el derecho legal de trabajar en los Estados Unidos? Si [ ] No [ ] Tiene algunas habilidades especiales, entrenamiento, o experiencia que ? Si [ ] No [ ] Si es asi, por favor explique

Tiene transportacion segura para llegar al trabajo? Si [ ] No [ ] Hay algunos dias de la semana que usted no este disponible para trabajar? Si [ ] No [ ] Si es asi, por favor explique

Tiene parientes trabajando para la compania? Si [ ] No [ ] Si es asi, quien? Ha trabajado para esta compania anteriormente? Si [ ] No [ ] Si es asi, cuando? Ha sido sentenciado por un crimen, no incluyendo delitos u ofensas sumarias? Si [ ] No [ ] (NOTA:Conviccion no necesariamente descalifica un aplicante.) Si es asi, por favor explique

Como encontro este trabajo?

CERTIFICACION Y RECONOCIMIENTO

Yo certifico que la informacion proporcionada aqui es verdadera y correcta a mi parecer. Entiendo que, si me emplean, las declaraciones falsificadas en esta Solicitud de Empleo seran consideradas como una razon para despido. Yo autorizo a la compania a investigar completamente mi experiencia del trabajo y cualquier otro asunto en relacion a la conformidad de este empleo. Tambien, autorizo a mis patrones anteriores para informar a la compania de cualquier y toda informacion que concierne a mi empleo pasado. Ademas, desligo a la compania, a mis jefes anteriores, y a otras personas, de cualquier y todos los reclamos, demandas, u obligaciones que pueden suceder o tener relacion con este informe. Reconozco que, si me emplean, la compania y yo tenemos el derecho de terminar esta relacion de empleo en cualquier momento, con o sin

the company and may not be modified by any oral or implied agreement. Applicant's Signature Date

Contact this candidate