Department

    Position(s) Applied For:

    Date of Application:

    Name

    Address

    City

    Zip

    Primary phone

    Work Phone

    If necessary, best time to call you

    Email address

    Are you 18 years of older?

    Have you applied with us before?

     

    How you been employed by us before?

    If yes, give dates:

    FROM

     TO

    Are you legally eligible for employment in this country?

    Proof of U.S. Citizenship or immigration status is required.

    Type of employment desired:

    Are you on layoff and subject to recall?

    Are you able to meet the attendance requirements of the position?

    Will you work overtime if required?

    Have you ever been bonded?

    Have you been convicted of a felony in the past seven (7) years?

    Such conviction may be relevant if job related, but does not bar you from employment.

    If yes, please explain:

    Driver's License Number

    State

    AN EQUAL OPPORTUNITY EMPLOYER

    EMPLOYMENT HISTORY

    List you last four (4) employers, assignments or volunteer activities, starting with the most recent, including military experience. Explain any gaps in employment in comments section below.

    Employer

    Dated Employed From / To

    Job Title

    Telephone

    Address

    Hourly Rate/Salary Starting

    Immediate Supervisor and title

    Reason for leaving

    Hourly Rate/Salary Final

    May we contact for reference?

    Employer

    Dated Employed From / To

    Job Title

    Telephone

    Address

    Hourly Rate/Salary Starting

    Immediate Supervisor and title

    Reason for leaving

    Hourly Rate/Salary Final

    May we contact for reference?

    Employer

    Dated Employed From / To

    Job Title

    Telephone

    Address

    Hourly Rate/Salary Starting

    Immediate Supervisor and title

    Reason for leaving

    Hourly Rate/Salary Final

    May we contact for reference?

    Employer

    Dated Employed From / To

    Job Title

    Telephone

    Address

    Hourly Rate/Salary Starting

    Immediate Supervisor and title

    Reason for leaving

    Hourly Rate/Salary Final

    May we contact for reference?

    Comments (including explination of any gaps in employment)

    Skills and Quualifications

    Summerise special skills and qualifications acquired from employment or other experiences that may qualify you to work with our company.

    EDUCATION BACKGROUND (IF JOB RELATED)

    A. List three (3) schools attended, starting witht he last one; B. List sumber of years compleeted; C. Indicate degree or diploma earned, if any; and D. Major and minor field of study (if applicable).

    A. School

    B. Number of Years completed

    C. Degree/Diploma

    D. Major/Minor

     

    References

    Name

    Business

    Telephone

    Years Known

     

    List any information you would like us to consider

    It is understood and agreed upon that any misrepreentation by me in this aplication will be suggicient cause for cancellation or this application and / or separation from the employer's service if I have been employed.

    I give th eEmployer the right to invesitgate all references and to secure additional information about me, if job related. I hereby release from liabiliity the Employer and its represenatives for seeking such information and all other persons, corporations or oganizations for furnishing such information

    The Employer is an Equal Opportunity Employer. The Employer does not discriminate in employment and no question on this ap- plication is used for the purpose of limiting or excusing any ap- plicant’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 just as I am free to resign at any time, the Employer reserves the right to terminate my employ ment at any time, with or without cause and without prior notice. I under- stand that no representative of the Employer has the authority to make any assurances to the contrary.

    NOTICE TO APPLICANTS
    Please be aware that as the Cadillac News has a policy of main- taining a drug-free work force and working environment, all ap- plicants for employment may be required to submit to urinalysis, blood test, or other screening as part of pre-employment physical examination, for the purpose of detecting the presence of alco- hol or illegal drugs. Applicants tested will be required to sign a Consent / Release form prior to testing, and any applicant refus- ing to sign any required form will be disqualified from further consideration.

    This alcohol and illegal drug screening will be performed by a licensed, certified testing service, and all applicants tested may be required to give a sample of the body fluid tested in the presence of another person, usually an employee of the testing service. A positive test may result in denial of employment.