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[Applicant] has applied for a position with our business, and you were listed as a former employer. [Applicant] has signed a release that authorizes you to give us the following information. [Give identifying information they ask for to help them find the applicants file. You may have to offer to send a copy of the applicants release to the former employer in order to get the information.]
Would you please verify that [Applicant] worked for your company from [date] to [date]?
What was [Applicants] job title?
Could you give me a brief description of the duties [Applicant] performed?
Please verify that [Applicants] final rate of pay was $[amount] hourly/weekly/biweekly/monthly/annually.
Was [Applicant] reliable?
Was the work [Applicant] performed satisfactory?
Did [Applicant] get along with coworkers and supervisors? [If relevant, with customers or clients?]
What was the reason given for leaving your employ?
Would you rehire [Applicant]?
Would you recommend [Applicant] for a position as [whatever position you are trying to fill]?
Thanks for taking the time to speak with me. Is there anything else that you think I might find helpful in making a hiring PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS
PLEASE COMPLETE PAGES 1-5. DATE
Name
Last First Middle Maiden
Present address
Number Street City State Zip
How long Social Security No. _______ - _____ - _________
Telephone ( )
If under 18, please list age
Position applied for (1) and salary desired () (Be specific) Days/hours available to work No Pref Thur Mon Fri Tue Sat Wed Sun
How many hours can you work weekly? Can you work nights?
Employment desired qFULL-TIME ONLY qPART-TIME ONLY qFULL- OR PART-TIME
When available for work?
TYPE OF SCHOOL NAME OF SCHOOL LOCATION (Complete mailing address) NUMBER OF YEARS COMPLETED MAJOR & DEGREE
High School
College
Bus. or Trade School
Professional School
HAVE YOU EVER BEEN CONVICTED OF A CRIME? q No q Yes
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
DO YOU HAVE A DRIVER’S LICENSE? q Yes q No
What is your means of transportation to work?
Driver’s license number State of issue _______ q Operator q Commercial (CDL) qChauffeur
Expiration date
Have you had any accidents during the past three years? How many?
Have you had any moving violations during the past three years? How Many?
OFFICE ONLY
q Yes q Yes Word q Yes Typing q No _____ WPM 10-key q No Processing q No _____ WPM
Personal q Yes PC q Computer q No Mac q Other Skills
Please list two references other than relatives or previous employers.
Name Name
Position Position
Company Company
Address Address
Telephone ( ) Telephone ( )
An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
MILITARY
HAVE YOU EVER BEEN IN THE ARMED FORCES? q Yes q No
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD? q Yes q No
Specialty Date Entered Discharge Date
Work Experience 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. Attach additional sheets if necessary.
Name of employer Address Name of last supervisor Employment dates Pay or salary
City, State, Zip Code Phone number From To Start Final
Your last job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of employer Address Name of last supervisor Employment dates Pay or salary
City, State, Zip Code Phone number From To Start Final
Your Last Job Title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
Work experience 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. Attach additional sheets if necessary.
Name of employer Address Name of last supervisor Employment dates Pay or salary
City, State, Zip Code Phone number From To Start Final
Your last job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of employer Address Name of last supervisor Employment dates Pay or salary
City, State, Zip Code Phone number From To Start Final
Your last job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
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