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Employment Application

Name*
First Last
Date*
MM slash DD slash YYYY
Phone Number*
Email*
Current Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you 18 years or older?*
- Yes
- No
Are you prevented from lawfully becoming employed in this country because of VISA or immigration status?*
- Yes
- No
Employment Position Desired*
Desired rate of pay?*
Are you employed now?*
- Yes
- No
If so, may we contact your current employer?*
- Yes
- No
Have you ever applied to this company before?*
- Yes
- No
Where/When?*
Referred by
Are you available to work full-time, part-time?
- Full-Time
- Part-Time
What days are you available to work?
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
Are you available to work overtime if needed?
- Yes
- No
On what date are you available to begin work?*
MM slash DD slash YYYY
Did you graduate from High School, College, or Trade School?*
- Yes
- No
Describe your special skills, area of study.
Special Skills
Activities (civic, athletic, groups, etc.)
Name & Address of Employer #1*
Dates of Employment (List Month/Year)*
Salary*
Position(s)*
Reason for Leaving*
Name & Address of Employer #2
Dates of Employment (List Month/Year)
Salary
Position(s)
Reason for Leaving
Name & Address of Employer #3
Dates of Employment (List Month/Year)
Salary
Position(s)
Reason for Leaving
Which of these jobs did you like best? What did you like most about this job?
Reference 1: Name/Address/Business/Years Acquainted*
Reference 2: Name/Address/Business/Years Acquainted*
Reference 3: Name/Address/Business/Years Acquainted
In case of Emergency, notify: Name/Address/Phone*
I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE. AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAY BE REJECTED AND, IF I AM EMPLOYED. MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME. IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE COMPANrS RULES AND REGULATIONS, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE. AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT EITHER MY OR THE COMPANYS OPTION. I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITIONS OF MY EMPLOYMENT MAY BE CHANGED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME BY THE COMPANY. I UNDERSTAND THAT NO COMPANY REPRESENTATIVE, OTHER THAN ITS PRESIDENT, AND THEN ONLY WHEN IN WRONG AND SIGNED BY THE PRESIDENT, HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING. (Signature/Date)*
Email
This field is for validation purposes and should be left unchanged.

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(231) 873-8833 silverlakebuggys@gmail.com

8288 W Hazel Rd, Silver Lake Sand Dunes, Mears, MI 49436-8697, US

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