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Test Employment App
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Position(s) Applied For
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Salary Desired
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Date of Application
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How did you learn about us?
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Employment Agency
Friend
Relative
Walk-In
Other
Name
*
First
Middle
Last
Address
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123 Example St., City, State, Zip Code
City
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State
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Zip Code
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Email
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Telephone Number
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If you are under 18 years of age, can you provide required proof of your eligibility to work?
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Yes
No
Have you ever filed an application with us before?
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Yes
No
If Yes, give date:
Have you ever been employed with us before?
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Yes
No
If Yes, list date of employment:
Are you currently employed?
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Yes
No
May we contact your present employer?
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Yes
No
Are you legally eligible for employment in the United States?
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Yes
No
You will be required to provide documentation verifying eligibility upon employment.
On what date would you be available for work?
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Are you available to work:
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Full Time
Part Time
Shift Work
Temporary
Are you currently on “Lay-off” status and subject to recall?
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Yes
No
Can you travel if the job requires it?
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Yes
No
Are you fluent in a foreign language? If so, what?
Do you possess the necessary physical ability to perform the job you have applied for?
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Yes
No
If no, please explain and state what can be done to accommodate your limitation.
Have you been convicted of a felony within the last 7 years?
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Yes
No
A conviction will not necessarily disqualify an applicant from employment.
If yes, please explain.
Employment Experience
You may be asked to provide additional employment history at a later date if needed.
Employer
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Address
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123 Example St., City, State, Zip Code
Telephone Number
*
Dates Employed
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Salary
Job Title
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Work Performed
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Reason for Leaving
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Employer
Address
123 Example St., City, State, Zip Code
Telephone Number
Dates Employed
Salary
Job Title
Work Performed
Reason for Leaving
Employer
Address
123 Example St., City, State, Zip Code
Telephone Number
Dates Employed
Salary
Job Title
Work Performed
Reason for Leaving
Education
High School
Did you receive a Diploma?
Yes
No
Other
If other, please explain.
Date Received:
College, University or Professional School
Location
Major/Minor
Years Completed
Degree Earned
Job-Related Training or Course Work
Name of school, years completed, and degree earned
Job-Related Training or Course Work
Name of school, years completed, and degree earned
Job-Related Training or Course Work
Name of school, years completed, and degree earned
Membership in Professional or Civil Organizations
Exclude those which may disclose your race, color, religion, or national origin.
Other Qualifications
Summarize special job skills and qualifications acquired or other experience relevant to your ability to perform the job.
Specialized Skills
*
PC
10-Key
Word
Excel
Access
PowerPoint
Accounting Software
Estimating Software
Typewriter
Photo Copier
Bluebeam/Adobe
Please check the office equipment you have experience working with.
Equipment/Truck Operation
Please list any additional equipment you are capable of operating.
State any additional information you feel may be helpful to us in considering your application.
Computer Skills
Word
*
Excel
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Outlook
*
PowerPoint
*
AutoCAD
*
Timberline
*
Training
Chemical Hazard Communication & SDS
First Aid Training
CPR Training
NESHAP-Asbestos
Lead Based Renovation Training
Forklift, Crane Rigging and Material Handling
OSHA 10-Hour Training
OSHA 30-Hour Training
Please check the training(s) that you have taken and are certified for. In the space below, please provide dates of certification for each.
Training Certification Dates
Example: CPR MM/YYYY, OSHA 10-Hour MM/YYYY, etc.
References
Name, Address, Phone Number, and Relationship
*
John Smith, 123 Example St., City, State, (000) 000-0000 Previous Boss of XYZ Company
Name, Address, Phone Number, and Relationship
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John Smith, 123 Example St., City, State, (000) 000-0000 Previous Boss of XYZ Company
Name, Address, Phone Number, and Relationship
*
John Smith, 123 Example St., City, State, (000) 000-0000 Previous Boss of XYZ Company
Please type your full name to E-Sign this employment application.
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