Position applying for:
Last Name
First Name
Middle
Address
City
State
Zip
Email Address
Home Phone #
()
-
Cell Phone #
()
-
Best time to reach you
Social Security Number
--
I am either a United States Citizen or an alien
who has the legal right to work in the job for
which I am applying:
Note: Pursuant to the immigration Reform and
Control Act of 1986, each applicant, upon being
made an offer of employment, must produce
documents, which are specified by the federal
government, establishing the applicant's
identity and authorization for employment in the
United States. These documents must be produced
not later than 72 hours after commencement of
employment. an applicant must also complete and
sign Form I-9 (issued by the federal government)
verifying under oath the applicant's identity
and employment authorization.
Are you at least 18 years of age?
I am available to start on
I can work the following: Hours
Days
Are you willing to work overtime as requested?
Are there any hours, shifts, or days you cannot
or will not work?
Explanation:
I have the following special qualifications
The minimum salary or wage I can accept is
I was previously employed by Harden Mfg from
to
as a
I was referred by
I am seeking employment with Harden Mfg because
Do any of your friends or relatives, other than
spouse, work here?
If yes, state name, relationship and location
Please list any other skills, licenses, or
certificates that may be job-related or that you
feel would be of value to this job or company.
Can you perform the requirements of any job without reasonable accommodations?
If no, please explain:
Describe any job-related training received in
the United States military:
Education
Highest level completed
Major
Name of school
Address of school
Work Experience
Start with your present or last
job. Include any job-related military
service assignments and volunteer
activities. You may exclude organizations
which indicate race, color, gender, national
origin, disabilities, or other protected
status.
Employer
Address
Telephone
Employed From
To
Hourly Rate/Salary Starting
$
Ending $
Starting/Present Job Title
Supervisor
Reason for Leaving
Employer
Address
Telephone
Employed From
To
Hourly Rate/Salary Starting
$
Ending $
Starting/Present Job Title
Supervisor
Reason for Leaving
Employer
Address
Telephone
Employed From
To
Hourly Rate/Salary Starting
$
Ending $
Starting/Present Job Title
Supervisor
Reason for Leaving
Employer
Address
Telephone
Employed From
To
Hourly Rate/Salary Starting
$
Ending $
Starting/Present Job Title
Supervisor
Reason for Leaving
Comments: Include explanation of any gaps in
employment.
