Name & Location: Graduate: ---noyes Major:
Name & Location: Graduate ---noyes Major:
Name: Address: Occupation:
Name: Address: Occupation: Are there any references that we shouldn’t contact? Are you a citizen of the United States? ---noyes If not, do you have the right to stay here permanently? ---noyes How did you get along with your old bosses? Were you ever treated unfairly? ---noyes Explain:
Month/Year
From: To: Name: Address: Salary: Position: Reason Left:
From: To: Name: Address: Salary: Position: Reason Left: What special qualities do you have that could benefit us? I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. I understand that this is not a contract and that no Manager, Supervisor or any other Representative of this Company other than Corporate Officers, has the right or authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing. Employees will understand that employment is terminable at the will of either party (Employer or Employee) at any time for any reason. There are no promises of long term employment. I AgreeI Disagree