Signed in as:
filler@godaddy.com
Site Content
Additional Information
Standard Application for Employment
It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classifications.
Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions on this application. You may attach a résumé, but all questions must be answered.
“Employer”
PERSONAL DATA
Name (last, first, middle)
Street Address and/or Mailing Address Home Telephone Number
Date you can start work
POSITION INFORMATION
Hours: Full Time Part Time
Position applying for
City
State Zip Cellular Telephone Number
Do you have a High School Diploma or GED?
Business Telephone Number Salary Desired
Check all that you are willing to work
Days Evenings
Yes
Swing Status: Graveyard
Weekends
Yes
Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment.) Yes If yes, explain:
No
Regular Temporary
No No
Are you authorized to work in the U.S. on an unrestricted basis?
Have you been told the essential functions of the job or have you been viewed a copy of the job description listing the essential functions of the job? Yes No
Can you perform these essential functions of the job with or without reasonable accommodation?
Yes
No
QUALIFICATIONS Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training.
School Name
Degree
Address/City/State
School School Other
SPECIAL SKILLS List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.
REFERENCES Please list three professional references not related to you, with full name, address, phone number, and relationship. If you don’t have three professional references, then list personal, unrelated references.
Name
Address/City/State
Phone
Relationship
WORK HISTORY
Job Title #1
Company Name City
Duties:
Reason for Leaving
May we contact your present employer? Job Title #2
Company Name City
Duties:
Reason for Leaving
Job Title #3
Company Name City
Duties:
Reason for Leaving
Job Title #4
Company Name City
Duties:
Reason for Leaving
Start with your present or most recent employment and work back. Use separate sheet if necessary. (INCLUDE PAID AND UNPAID POSITIONS)
Start Date (mo/day/yr) Supervisor’s Name State
End Date (mo/day/yr) Phone Number
Zip
Ending Salary
End Date (mo/day/yr) Phone Number
Zip
Ending Salary
End Date (mo/day/yr) Phone Number
Zip
Ending Salary
End Date (mo/day/yr) Phone Number
Zip
Ending Salary
Yes
Starting Salary
No
N/A
Start Date (mo/day/yr) Supervisor’s Name State
Starting Salary
Start Date (mo/day/yr) Supervisor’s Name State
Starting Salary
Start Date (mo/day/yr) Supervisor’s Name State
Starting Salary
I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application.
I acknowledge and understand that the company is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party.
Applicant Signature Date