Employment Application

Name

First Name

Last Name

Date of Birth

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Date Available To Start

YYYY

Desired Hourly Rate

Do you have a driver's license?

Do you have reliable transportation?

Are you legally eligible to work in the U.S.?

Have you ever been convicted of a felony?

If yes, please explain.

Highest Level of Education Completed

Resume

Employment History

Employment History - Job #1

Employment History - Job #2

Employment History - Job #3

Ideally, how many hours would you like to work per week?

Working Weekends (what is your ideal situation)?

Why are you interested in this position?

How would your friends/family describe you?

References

Please provide the name, relationship and phone number of 3 references (exclude relatives & former employers).

Please list any additional comments or information that you think might be relevant.