Employment Application

Complete the form and Click "Submit" at bottom of page to send the application.

Personal Information

First Name:

Last Name:

Social Security Number:

Address:

City:

State:

Zip Code:

Phone Number:

E-Mail Address:

Are you eligible to work in the United States?

Yes: No:

Have you ever been convicted of or pleaded no contest to a felony?

Yes: No:

If yes, please explain:

Position/Availability

Desired Position:

What date are you available to start work:

Desired Wages:

Availability:

Full-Time: Part-Time:

Currently Employed:

Yes: No:

Education

High School

High School:

Location:

High School Completed?

Yes: No:

Degree/Diploma:

College

College:

Location:

College Completed?

Yes: No:

Degree/Diploma:

Skills and Qualifications: Licenses, skills, training:

Employment History

Present or Last Position

Employer:

Address:

Supervisor:

Phone:

Contact your Supervisor?

Yes: No:

Position Title:

Responsibilities:

Start Date:

End Date:

Beginning Salary:

Ending Salary:

Reason for leaving:

Previous Position

Employer:

Address:

Supervisor:

Phone:

Contact your Supervisor?

Yes: No:

Position Title:

Responsibilities:

Start Date:

End Date:

Beginning Salary:

Ending Salary:

Reason for leaving:

Reference

Name:

Affiliation:

Address:

Phone:

Other Reference

Name:

Affiliation:

Address:

Phone:

I certify that information contained in this application is true and complete.

I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.

Signature

Signature:

Date:

Employment Application

Education

Employment History

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Copyright © 2008 Stephens Electronics, Inc.Site Design by: shockEnterprise
Page Execution Time: 0.025 seconds