EMPLOYMENT APPLICATION
APPLICANT INFORMATION
Last Name Johnson
First Teresa
M.I. Lynette
Date 6/10/2023
Street Address ***** * ******* ******
Apartment/Unit #3
City Chicago
State Illinois
ZIP 60628
Phone 779-***-****
E-mail Address adxmwc@r.postjobfree.com
Date Available asap
Social Security No.***-**-****
Desired Salary 17.00 hr +
Position Applied for Room attendant
Are you a citizen of the United States?yes
YES
NO
Do you hold a Permanent Employee Registration Card?yes
YES
NO
Have you previously been employed by MPSI?no
YES
NO
If so, when?
Have you ever been convicted of a felony?no
YES
NO
If yes, explain
EDUCATION Dusable
High School
City and State Chicago Illinois
From 1985
To
1989
Did you graduate?yes
YES
NO
Degree diploma
College computer system institute
Address Chicago Illinois
From 2011
To 2012
Did you graduate?yes
YES
NO
Degree certificate
Other
Address
From
To
Did you graduate?
YES
NO
Degree
REFERENCES
Please list three professional references.
Full Name yolanda mosley
Relationship friend
Company child care pro
Phone 773-***-****
Address Chicago Illinois
Full Name Mildred Newell
Relationship friend
Company amber wood nursing facility
Phone 773-***-****
Address Chicago Illinois
Full Name shaniece Favors
Relationship landlord
Company globe realty
Phone 773-***-****
Address Chicago Illinois
CURRENT / PREVIOUS EMPLOYMENT
Company Titan security
Phone 773-***-****
Address
Supervisor
Job Title
Starting Salary
$
Ending Salary
$
Responsibilities
From
To
May we contact your supervisor for a reference?
YES
NO
Company
Phone
Address
Supervisor
Job Title
Starting Salary
$
Ending Salary
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
Company
Phone
Address
Supervisor
Job Title
Starting Salary
$
Ending Salary
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
MILITARY SERVICE
Branch
From
To
Rank at Discharge
Type of Discharge
If other than honorable, explain
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Employees, while conducting agency business, are not permitted to carry any firearm even if they have been granted an Illinois Concealed Carry License. Employees may only carry a firearm while conducting any agency business if they have been issued a Firearm Control Card by MPSI of Illinois Inc. and the Illinois Department of Financial and Professional Regulation. Failure to adhere to this policy or applicable state laws can lead to discipline up to, and including, termination. As a condition of employment, MPSI of Illinois Inc. employees are required to follow this policy and all applicable laws governing concealed carry and the possession of firearms, weapons, and ammunition while conducting business on MPSI of Illinois Inc.’s behalf.
Signature
Date