Premier Products, Inc. - Employment Application Form
PLEASE COMPLETE ALL OF THE INFORMATION REQUESTED IN THE APPLICATION FORM
Complete the following application and click “Submit” once you have verified that you have answered every question and that the information entered is correct.
OFFICE USE ONLY:
Date received:
Reviewed by:
PLEASE COMPLETE THE ENTIRE FORM.
DATE
Name
Last
First
Middle
Maiden
Present address
Number
Street
City
State
Zip
How long at current address?
Telephone E-mail Address
Are you under age 18 YES NO, if “YES”, can you provide proof of your eligibility to work? YES N0
Are you currently authorized to work in the United States? YES NO.
Proof of eligibility will be required if hired.
Days/hours available to work
Position applied for (1)
Any
YES
Thu
and wage desired (2)
Mon
Fri
(Be specific)
Tue
Sat
Wed
Sun
How many hours can you work weekly?
Employment desired FULL-TIME ONLY PART-TIME ONLY FULL- OR PART-TIME
When are you available to start work?
TYPE OF SCHOOL
NAME OF SCHOOL
LOCATION (Complete mailing address)
NUMBER OF YEARS COMPLETED
MAJOR & DEGREE
High School Graduated From
College or University
Bus. or Trade School
Professional School
Have you ever been convicted of a crime? No Yes
(A conviction record will not necessarily disqualify you from employment).
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.
DO YOU HAVE A DRIVER’S LICENSE? Yes No
What is your means of transportation to work?
Driver’s license State of issue Operator Commercial (CDL) Chauffeur
Expiration date
Have you had any accidents during the past three years? Yes No
How many?
Have you had any moving violations during the past three years? Yes No
How Many?
OFFICE POSITIONS ONLY
Typing Yes 10-key Yes Word Yes
No No Processing No
Personal Yes PC
Computer No Mac
Other Skills
Please list two references other than relatives.
Position
Company
Address
Telephone
Please use this space to elaborate on any background, experience, or qualifications that you believe should be considered in evaluating your qualifications for employment. You may include hobbies, volunteer experience and any other activities you believe relevant. Please omit any information that would disclose your race, gender, age, marital status, ethnic origin, religious or political affiliations, or disability.
MILITARY EXPERIENCE
HAVE YOU EVER BEEN IN THE ARMED FORCES? Yes No
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD? Yes No
Specialty Date Entered Discharge Date
Work Experience
Please list your work experience beginning with your most recent job held. If you were self-employed, give firm name.
Name of Employer
Name of last supervisor
Employment Dates
Pay or salary
City, State, Zip Code
From
Start
Phone Number
To
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.
