APPLICATION FOR EMPLOYMENT

(Pre-Employment Questionnaire) (An Equal Opportunity Employer)

PERSONAL INFORMATION:
	DATE : / /
NAME :
PRESENT ADDRESS :
PERMANENT ADDRESS
PHONE
ARE YOU 18 YEARS OR OLDER?	Yes No
ARE YOU PREVENTED FROM LAWFULLY BECOMING EMPLOYED IN THIS COUNTRY BECAUSE OF VISA OR IMMIGRATION STATUS?	Yes No

EMPLOYMENT DESIRED:
POSITION :	DATE YOU CAN START : / /
SALARY YOU DESIRED :
ARE YOU EMPLOYED NOW?	Yes No
IF SO MAY WE INQUIRE OF YOUR PRESENT EMPLOYER?
EVER APPLIED TO THIS COMPANY BEFORE?		Yes No
WHERE?	WHEN?
REFERRED BY :

EDUCATION	NAME AND LOCATION OF SCHOOL	*NO OF YEARS ATTENDED	*DID YOU GRADUATE?	SUBJECTS STUDIED
GRAMMAR SCHOOL
HIGH SCHOOL
COLLEGE
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL

GENERAL

SUBJECTS OF SPECIAL STUDY OR RESEARCH WORK :

SPECIAL SKILLS :

ACTlVITIES: (CIVIC ATHLETIC ETC.)

EXCLUDE ORGANIZATIONS, THE NAME OF WHICH INDICATES THE RACE, CREED. SEX. AGE, MARITAL STATUS, COLOR OR NATION OF ORIGIN OF ITS MEMBERS.


U. S MILITARY NAVAL SERVICE	RANK	PRESENT MEMBERSHIP IN NATIONAL GUARD OR RESERVES

FORMER EMPLOYERS (LIST BELOW LAST THREE EMPLOYERS, STARTING WITH LAST ONE FIRST).
DATE MONTH & YEAR	NAME AND ADDRESS OF EMPLOYER	SALARY	POSITION	REASON FOR LEAVING
FROM
TO
FROM
TO
FROM
TO
FROM
TO
WHICH OF THESE JOBS DlD YOU LIKE BEST?
WHAT DlD YOU LIKE MOST ABOUT THIS JOB?

REFERENCES: GIVE THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.
NAME	ADDRESS	BUSINESS	YEARS ACQUAINTED




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