Employment Application

 

 

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Please be certain to complete entirely. Failure to complete all information, may result in immediate rejection of your application.

Personal History
Your E-Mail Address
First Name
Middle Name (If applicable)
Last Name
Street Address
Street Line 2
City
State
ZIP
How Long?
 
Home Phone
Best Time To Call:A.M./P.M.?
 
Business Phone
Best Time To Call:A.M./P.M.?
 
Cellular Phone/Pager
Best Time To Call:A.M./P.M.?
 
Previous Street Address
Previous Street Line 2
Previous City
Previous State
Previous ZIP
How Long?
 

Scheduling Availability


 
Full-Time
Part-Time
Full-Time-but will accept Part-Time
Available Date
 
Weekend Availability?
State Days Available
State Hours Available
 

Employment History


Currently Employed?
 
Start with current employment or most recent employment first
 
Employer #1
Employer Address/City
Employer Telephone No:
Describe your duties:
Reason for Leaving
State Period of Employment
State starting salary/wage
State ending salary/wage
State starting position/title
State ending position/title
 
 
Employer #2
Employer Address/City
Employer Telephone No:
Describe your duties:
Reason for Leaving
State Period of Employment
State starting salary/wage
State ending salary/wage
State starting position/title
State ending position/title
 
 
Employer #3
Employer Address/City
Employer Telephone No:
Describe your duties:
Reason for Leaving
State Period of Employment
State starting salary/wage
State ending salary/wage
State starting position/title
State ending position/title
 
Which of these jobs did you like the most and why?
 

Education


High School / GED
Graduated?
College
College Graduate
 
Graduate School
Graduate?/Degree?
 
Business/Trade School
Graduate?/Degree?
 
Military
Graduate?/Degree?
 
Years of Schooling Achieved 6-20
 

Military Service Record


Branch of Service
Job Duty
Reason for Discharge
Starting Rank
Date of Separation
Rank at Separation
Describe special duties/training that may help in your job application
 

Special Skills


Accounts Payable
 
Accounts Receivables
 
Benefits CRT Operator
 
General Cost Accounting
 
Inventory Control
 
Office Phone Equipment
 
Payroll
 
WordProcessing
 
10-key by touch
 
MS Word Skills
 
MS Excel Skills
 
MS Power Point
 
MS Office
 
Windows Operating Systems (W95/98/2000/NT)
 
Linux/Unix/FreeBSD/BEOS Operating Systems
 
Novell Network Operating Systems
 
Other skills not mentioned
 
Design/Typesetting/Desktop Publishing
 
Webpage/PERL/HTML/VRML Programming
 
Computer Programming
 
Typing Skills WPM
State additional Softwares you consider yourself an expert with
 

General Information


Possess a valid Arizona Driver's License?
 
Is your vehicle currently insured for liability?
 
Could you provide proof of insurance?
 
How did you learn about employment opportunities with our Company?
 
State any friend's or relatives working for this Company? (if applicable)
 
State any comments/questions about this online application
 
I affirm that the information provided in this employment application is true and complete to the best of my knowledge. I understand that any false information, misrepresentation or omissions may disqualify me from further consideration for employment or may result in dismissal if discovered at a later date. I understand that if I am hired, the information given in this application will become part of my personnel record. I authorize the company to make a thorough investigation of my previous employment, education, and background in connection with it's information which it receives. Notwithstanding the above, this authorization does not apply to disability and medical related information that is prohibited from disclosure by the Americans With Disabilities Act. I agree that, if employed, I will abide by the policies, procedures, rules, and regulations of the Company. I agree, notwithstanding any representations contained in the Company's employee handbook, if it applies to me, and as it may be modified from time to time, constitute the sole and exclusive procedure for the termination from employment. I further agree that, if hired, any money I owe the Company may be taken out of any monies I am due including, but not limited to, wages, bonuses, and vacation pay. I understand that it is a violation of Company policy for any employee to sell, distribute, manufacture, dispense, possess, use, purchase or have in his or her system a prohibited level of alcohol or controlled substance while on Company premises or during Company business time. I further understand that I may be required to submit to drug and/or alcohol tests in connection with applying for employment with the Company. I understand that if I am required to undergo such tests, I must pass such tests before I may be offered employment. I also understand that refusal to submit to, or cooperate fully with, the administration of an alcohol or drug test will result in my disqualification from employment and that any attempt to invalidate or circumvent the drug or alcohol test will result in my disqualification. I further understand that if I am hired, there may be circumstances under which I may be required to submit to drug and alcohol tests and that I must cooperate fully in the administration of such tests. I hereby consent to the disclosure of all test results by the testing facility to the Management of the Company. I understand that under Federal law, if an offer of employment is made to me, I must present to the Company original documents establishing my identity and authorization to work in the United States. I understand that offer of employment that is made to me is conditioned upon my being able to present such documents that are acceptable under the law include, but are not limited to, (1) a U.S. passport;(2) alien registration card with photograph;(3) a driver's license and a social security card; and (4) a driver's license and a birth certificate. I understand that this application will be in effect for 90 days from the date indicated below and that if employment is not offered within the 90-day period, I must reapply to be considered for future employment.
I have read the above paragraphs, I understand their importance and effect upon my opportunity for employment, and accept them as conditions of employment by this company should I be offered and accept employment.
 
 

 

 

 


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