Employment Application

Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Phone

Date Available

Desired Salary

Position Applied For

Are you a citizen of the United States?

Yes
No

If no, are you authorized to work in the U.S.?

Yes
No

Have you ever worked for this company?

Yes
No

If yes, when?

Have you ever been convicted of a felony?

Yes
No

If yes, explain

Education

High School

From:

To:

College

From:

To:

(Reference Email If

Other

From: (copy)

To: (copy)

References

Full Name of Company (Reference One)

Relationship

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Full Name of Company (Reference Two)

Relationship

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Previous Employment

Full Name of Company

Phone

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes
No

Full Name of Company

Phone

Job Title:

Starting Salary:

Ending Salary:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference? (copy)

Yes
No

Military Service

Branch:

From:

To:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature

Clear Signature

Date / Time

Employment Application

Education

References

Previous Employment

Military Service

Disclaimer and Signature

HOURS

THE SIDELINE SPORTS BAR