JTG-TF Employment Application 01.08.09

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  Application for Employment
PLEASE PRINT
 
MG300 
 AN EQUAL OPPORTUNITY EMPLOYER
 
Position(s) Applied For__________________________________________________________________________ Date of Application ______/______/______ Name __________________________________________________________________________________________________________________________
LAST FIRST MIDDLE
 Address_________________________________________________________________________________________________________________________ 
STREET CITY STATE ZIP CODE
Telephone (______)___________---_____________________________ Social Security Number _______________-- _________ -- ________________
 AREA CODE
If you are under 18, can you furnish a work permit? …………………………………………………………………………………………………………. YES NO Have you ever been employed here before? …………………………………………………………………………………………………………………. YES NO  Are you legally eligible for employment in this country?
(
Proof of U.S. citizenship or immigration status will be required upon employment.
)
…………………………. YES NO Date available of work ______/______/______ Type of employment desired…………. Full Time Part-time Temporary Seasonal Educational Co-op  Are you able to meet the attendance requirements of the position? ………………………………………………………………………………………... YES NO Have you been convicted of a felony in the last seven (7) years? ………………………………………………………………………………………….. YES NO
(Such conviction may be relevant if job related, but does not bar you from employment.)
If yes, please explain: _____________________________________________________________________________________________________________  _______________________________________________________________________________________________________________________________ Driver’s license number (if required by job) __________________________________________________________________________ State ___________ How did you find out about this job?: __________________________________________________________________________________________________
Employment History
List your last four (4) employers, assignents or volunteer activities, starting with the most recent, including military experience. m
Employer 
 
From To Telephone
(include area code
)
 
Job Title
 
 Address
 
Immediate Supervisor and Title
 
Summarize the nature of work performed and job responsibilities
 
Reason for leaving
 
Hourly Rate / Salary Start $ per / Final $ per 
 
From To Employer 
 
Telephone
(include area code
)
 
Job Title
 
 Address
 
Immediate Supervisor and Title
 
Summarize the nature of work performed and job responsibilities
 
Reason for leaving
 
Hourly Rate / Salary Start $ per / Final $ per 
 
From To Employer 
 
Telephone
(include area code
)
 
Job Title
 
 Address
 
Immediate Supervisor and Title
 
Summarize the nature of work performed and job responsibilities
 
Reason for leaving
 
Hourly Rate / Salary Start $ per / Final $ per 
 
From To Employer 
 
Telephone
(include area code
)
 
Job Title
 
 Address
 
Immediate Supervisor and Title
 
Summarize the nature of work performed and job responsibilities
 
Reason for leaving
 
Hourly Rate / Salary Start $ per / Final $ per 
 
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  Application for Employment
PLEASE PRINT
 
MG300 
 AN EQUAL OPPORTUNITY EMPLOYER
 
Skills and Qualifications
Summarize special skills and qualifications acquired from employment or other experiences that may qualify you for work with our company.
Educational Background
Name and Location Years Completed Did you Graduate? Course of Study
High School College Major Degree Other
References
Name Telephone
INCLUDE AREA CODE
Years Known
PLEASE READ……………………………………………………………………………………………………………………………………………………………………………………….
 
 It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and / or separation from the Employer’s service if I have been employed.
 I give the Employer the right to investigate all references and to secure additional information about me, if related. I hereby release from liability the Employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.
 The Employer is an Equal Opportunity Employer. The Employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local, state, or federal law.
 This application is current for only 60 days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will be necessary to fill out a new application.
 I understand that as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary.
Date:
/ /
Signature of Applicant
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