North Rose-Wolcott - Introduction to Occupations
North Rose-Wolcott - Introduction to Occupations
Employment Application
Employment Application
PERSONAL DATA:
Name __________________________________________ DOB ____________ SS# (optional) _______________________
Address ___________________________________________________________________ Phone ___________________________
TYPE OF WORK:
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What position are you applying for? ______________________________________________________________________________
Expected wage ________________________ Date available to start work __________________________________________
All positions are Part-Time and last for one (10) week marking period.
EDUCATION:
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High School Last Grade Completed Major Type of Diploma
____________________________________________________________________________________________________________
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College or Trade School Years Completed Major Diploma / Degree
____________________________________________________________________________________________________________
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Other Schooling Years Completed Major Diploma / Degree
____________________________________________________________________________________________________________
EMPLOYMENT HISTORY: (list most recent employment first)
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Employer Address Phone
____________________________________________________________________________________________________________
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Position held Supervisor’s Name Starting Pay Ending Pay Reason for Leaving
____________________________________________________________________________________________________________
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Employer Address Phone
____________________________________________________________________________________________________________
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Position held Supervisor’s Name Starting Pay Ending Pay Reason for Leaving
____________________________________________________________________________________________________________
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Employer Address Phone
____________________________________________________________________________________________________________
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Position held Supervisor’s Name Starting Pay Ending Pay Reason for Leaving
____________________________________________________________________________________________________________
REFERENCES: (List at three personal references not related to you.)
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Name Address Phone
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
HEALTH:
Do you have or have you had any serious prolonged illness? If so, describe. Y / N ________________________________________
In case of emergency, notify:
Name _______________________________________________________ Phone _____________________________________
Address ____________________________________________________________________________________________________
Please give any additional information you feel may be helpful when considering your application.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Please Read Carefully and Sign:
I understand that this application for employment will be given every consideration, but its receipt does not constitute a contract of employment, not does it imply that I will be hired.
I certify that al answers given on this employment application are true and complete to the best of my knowledge and that any misrepresentation of omission is sufficient cause for immediate termination of employment by the employer without incurring any liability or obligation.
I hereby acknowledge that I have read and understand this agreement.
Signature of Applicant Date
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