Where Your Decorating Dreams Become Realities
Application For Employment
Personal Information
Date
Name (Last Name, First)
Social Security No
.
Present Address
City
State
Zip
Permanent Address
City
State
Zip
Phone
Referred By
Employment Desired
Positions Desired
Date You Can Start
Salary Desired
Are You Currently Employed
Yes
No
If So, May We Inquire Of Your Present Employer?
Yes
No
Ever Applied To This Company Before?
Yes
No
Where?
When?
Education History
Name & Location Of School
Years Attended
Did You Graduate?
Subjects Studied
Grammar School
High School
College
Trade, Business or Correspondence School
General Information
Subjects Of Special Study/Research Work Or Special Training/Skills
U.S Military Or Naval Service
Rank
Former Employers
(List Below Last Four Employers, Starting With Last One First)
Date Month And Year
Name & Address of Employer
Salary
Position
Reason For Leaving
From
To
Name
Address
Address
From
To
Name
Address
Address
From
To
Name
Address
Address
From
To
Name
Address
Address
References
(Give Below The Names Of Three Persons Not Related To You, Whom You Have Known At Least One Year)
Name
Address
Business
Years Known
Authorization
"I certify that the facts contained in the application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
I agree with the above Authorization Statement
I disagree with the above Authorization Statement
Dated
Typed Signature
