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| * Social Security Number: |
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| * Position(s) applied for: |
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| * Available: |
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| * Type of employment desired: |
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| * What shifts are you available? |
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| * Are you legally eligible for employment in this country? |
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| * Are you available to work overtime if required? |
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| * Are you available to work weekends if required? |
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| * Have you been employed at this company before? |
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| * Have you ever been convicted of a crime (excluding misdemeanors and traffic offenses)? |
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| If YES, please list convictions (a conviction does not necessarily disqualify an applicant of the position being applied for) |
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| EDUCATIONAL BACKGROUND: List previous three educational institutions attended, beginning with the most recent. |
| * School/City, State/Level Completed or Degree Attained |
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| * School/City, State/Level Completed or Degree Attained |
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| * School/City, State/Level Completed or Degree Attained |
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| EMPLOYMENT BACKGROUND: Provide the following information beginning with the most recent employer.
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| * Employer (1) |
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| Work Performed and Responsibilities (1) |
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| * Starting Hourly Rate/Salary (1) |
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| * Ending Hourly Rate/Salary (1) |
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| * Immediate Supervisor (1) |
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| * May we contact for reference? (1) |
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| (Second Employment Entry) |
| * Employer (2) |
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| * Work Performed and Responsibilities (2) |
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| * Starting Hourly Rate/Salary (2) |
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| * Ending Hourly Rate/Salary (2) |
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| * Immediate Supervisor (2) |
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| * May we contact for reference? (2) |
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| (Third Employment Entry) |
| * Employer (3) |
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| * Work Performed and Responsibilities (3) |
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| * Starting Hourly Rate/Salary (3) |
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| * Ending Hourly Rate/Salary (3) |
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| * Immediate Supervisor (3) |
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| * May we contact for reference? (3) |
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| (Fourth Employment Entry) |
| * Employer (4) |
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| * Work Performed and Responsibilities |
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| * Starting Hourly Rate/Salary (4) |
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| * Ending Hourly Rate/Salary (4) |
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| * Immediate Supervisor (4) |
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| * May we contact for reference? (4) |
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| Explanation of Any Gaps in Employment: |
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| PLEASE ANSWER THE FOLLOWING QUESTIONS |
| * What was the best job you’ve ever had? Why did you like it so much? |
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| * What was your least favorite job? What did you NOT like about it? |
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| * Who was the best supervisor or manager you’ve had? What characteristics made that person a good manager? |
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| * Think of the WORST supervisor or manager you’ve had. What characteristics made that person a POOR manager? |
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| * What are your greatest strengths? |
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| * As your skills and abilities relate to your work experiences, what are the areas for improvement? |
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| * What traits or characteristics do you most admire in co-workers? |
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| * If you won five million dollars in the lottery, would you choose to work? What would you do with your time? |
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| * What was the funniest thing that ever happened to you at work? |
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| * What do you think is the most difficult part of sales / customer service work? |
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| * Imagine you have been on your feet and working hard all day. A customer has a crisis that requires extra effort. What do you do? |
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| REFERENCES
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| * List the name, relationship, number of years acquainted, and phone number of three references. (No relatives please). |
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