Application For Employment

Application For Employment

Date:___________

PERSONAL INFORMATION:

SOCIAL SECURITY #:

NAME

LAST

FIRST

MIDDLE

PRESENT ADDRESS

STREET

CITY

STATE

ZIP CODE

PERMANENT ADDRESS

STREET

CITY

STATE

ZIP CODE

PHONE NUMBER

( ) -

IF RELATED TO

ANYONE IN OUR

EMPLOY STATE NAME:

REFERRED BY:

HAVE YOU BEEN CONVICTED OF A FELONY OR MISDEMEANOR CRIME WITHIN THE LAST 7 YEARS THAT HAS NOT BEEN EXPUNGED, SEALED, IMPOUNDED OR ANNULLED?

□ YES □ NO

IF YES, STATE DETAILS: CONVICTIONS WILL NOT NECESSARILY DISQUALIFY APPLICANT; EACH CASE IS CONSIDERED INDIVIDUALLY.

EMPLOYMENT DESIRED:

POSITION

DATE YOU CAN START

SALARY DESIRED

EVER APPLIED TO THIS COMPANY BEFORE?

WHERE?

WHEN?

FULL TIME

PART TIME

HOURS PER WEEK IF PART TIME

EDUCATION:

	NAME AND LOCATION	GRADUATED?		MAJOR SUBJECTS	AVG. GRADES
HIGH SCHOOL		YES	NO

COLLEGE		YES	NO

TRADE OR CORRESPONCE SCHOOL		YES	NO

AVAILABILITY

	MON	TUES	WEDS	THURS	FRI	SAT	SUN
FROM:
TO:

CONSISTENT ATTENDANCE AND PUNCTUALITY ARE ESSENTIAL EQUIREMENTS OF EVERY JOB WITH THIS COMPANY. IS THERE ANYTHING THAT WOULD INTERFERE WITH YOUR REGULAR ATTENDANCE AND PUNCTUALITY IF YOU ARE OFFERED A JOB WITH THE COMPANY?

□ YES □ NO

IF YES, PLEASE EXPLAIN:

RIDING EXPERIENCE (OPTIONAL):

NUMBER OF YEARS RIDING:

	STREET	OFF ROAD	BOTH	NEITHER
I RIDE:
I RACE:

FORMER EMPLOYERS:

DATES

MONTH & YEAR

NAME, ADDRESS & PHONE NUMBER

SALARY

POSITION

REASON FOR LEAVING

FROM:

PHONE: ( ) -

TO:

FROM:

PHONE: ( ) -

TO:

FROM:

PHONE: ( ) -

TO:

FROM:

PHONE: ( ) -

TO:

REFERENCES:

NAME

ADDRESS AND/OR PHONE NUMBER

BUSINESS

YEARS AQUAINTED

IN CASE OF

EMERGENCY NOTIFY:

NAME

ADDRESS

PHONE NUMBER

Other Qualifications:

Job-related training courses (give title and year). Job-related skills (other languages, computer software/hardware, tools, machinery, typing speed, etc.). Job-related certificates and licenses (current only). Job-related honors, awards, and special accomplishments (publications, memberships in professional/honor societies, leadership activities, public speaking, and performance awards). Give dates, but do not send documents unless requested.

NOTIFICATION AND AGREEMENT

Questions regarding this statement should be directed to any employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

I certify that all answers given by me are true, accurate, and complete, to the best of my knowledge. I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I release the employer from all liability that might result from making an investigation. I understand that any deliberate misrepresentation, deception, or false statement made in this Employment Application (or any other accompanying or required documents) may result in my not being considered for employment, and if not discovered by the Company until after my becoming employed, is grounds for, and may result in, my immediate termination.

It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, or disability and any other characteristic protected by Federal, State or Local law.

If hired, I agree to abide by all of the company rules and regulations, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the company or me. I further understand that no representation, whether oral or written by any representative or agent of the Company, at any time, can constitute a contract of employment.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me.

APPLICANT SIGNATURE _________________________________ DATE ________