EMPLOYMENT DESIRED
Which position are you
seeking?
Hourly wage or salary desired?
Note: Don’t give a salary on the application. You may price yourself out of
the job if your number is too large or you may look desperate if you’re asking
too little. Instead, just write, “Standard wage” or put the salary listed in the
position description if you must fill in a number.
What type of work are you
seeking? (Circle one)
Full-time Part-time Seasonal Temporary
Days and Hours Available:
______ Monday
______ Tuesday
______ Wednesday
______ Thursday
______ Friday
______ Saturday
______ Sunday
Hours Available: ______ to ______
Hours Available: ______ to ______
Hours Available: ______ to ______
Hours Available: ______ to ______
Hours Available: ______ to ______
Hours Available: ______ to ______
Hours Available: ______ to ______
Are you available to work
holidays?
Are you available for
overtime?
When will you be available to
begin work?
If hired, will you have reliable
transportation to and from
work?
Have you ever been employed
with us in the past?
If yes, what was your job title
and department?
Supervisor’s Name and Phone
Number
Location of Employment
Dates of Employment
Reason for Leaving
Do you have a friend or
relative that is employed by
us?
If yes, what is their name?
If yes, call your friend or relative and ask if you can put their name on the
application. Also, ask if they would put in a good word for you.
Job Title and Department
Location of Employment
Phone Number