252.752.8274 252.752.9016

Application for Employment

Full Name:*

Present Address*

How long have you live there?*

Social Security *

Phone:*

Under 18 years old?

Yes No

Position Applied For*

Salary Desired:*

Days/Hours available to work:*

How many hours can you work weekly?*

Employment desired:*

Type of school?

Please list name of school, College, Trade School, Professional School, with location with complete mailing address, number of years completed, major and degree.

*

Have you ever been convicted of a crime?

Yes No

Do you hve a driver license?

Yes No

Driver's license number *

State of issue*

Type of license

Operator Commercial (CDL) Chauffeur

Have you had accidents in the past three years?

Yes No

If yes, how many?

Have you had any moving violations during the past three years?

Yes No

If yes, how many?

Have you been in the armed forces?

Yes No

Are you a member of the national guard?

Yes No

Work Experiance

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name

Name or employer, address, city, state, zipe code and phone number*

Name of last supervisor:*

Employment Dates (From - To)*

Pay or salary ( Start- Final)*

Your last job title:*

Reason for leaving:*

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.*

Name of employer address, city, state, zip code, phone number*

Name of last supervisor

Employment date (from- to)*

Pay or Salary (From - To)*

Your last job title*

Reason for leaving*

List the jobs you held duties performed, skills used or learned, advancements or promotions while you worked at this company.*

Name of employer, Address, City, State. Zip code, Phone Number*

Name of last supervisor:

Employer Dates ( From - To )*

Pay or Salary ( From - To)*

Reason for leaving:*

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.*

May we contact your present employer?

Yes No

Agreement

I certify that information containd in this application is true and complete. I understand that false inforamtion at any point in the future in I am hired. I autherize the vrification of any or all information listed above.

I Agree I Disagree