Employment Application
Personal Information
Name
Street Address
City
State
Zip
Phone
Alt. Phone
E-Mail Address
Position Information
Position for which you are applying:
Office Manager
Other
Are you employed at the present time?
Select one...
Yes
No
If offered a position, when can you report for work?
Are you 18 years of age or older?
Select one...
Yes
No
Are you authorized to wrok in the U.S. on an unrestricted basis?
Select one...
Yes
No
Have you ever been convicted of a felony?
Select one...
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 program and military training.
School #1
School Name
Date Attended
Degree
Location
School #2
School Name
Date Attended
Degree
Location
School #3
School Name
Date Attended
Degree
Location
Special Skills
List any special skills or experience that you feel would help you in the position 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.
Reference #1
Name
Address
Phone
Email
Relationship
Reference #2
Name
Address
Phone
Email
Relationship
Reference #3
Name
Address
Phone
Email
Relationship
Work History
Work History #1
Job Title
Start Date
End Date
Company Name
Supervisor's Name
Phone Number
Address
Job Responsibilities
Reason For Leaving
Starting Salary
Ending Salary
Work History #2
Job Title
Start Date
End Date
Company Name
Supervisor's Name
Phone Number
Address
Job Responsibilities
Reason For Leaving
Starting Salary
Ending Salary
Work History #3
Job Title
Start Date
End Date
Company Name
Supervisor's Name
Phone Number
Address
Job Responsibilities
Reason For Leaving
Starting Salary
Ending Salary
Certification
I certify that the facts set forth in this application 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.
I agree to these terms and conditions
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