|
| Date: (mm/dd/yyyy) |
|
| Position applied for: |
|
| Full Name: (First, Middle, Last) |
|
| Social Security Number: |
|
| Address: |
|
|
| City: |
|
State:
Zip Code:
|
| Home Telephone Number: |
|
| E-Mail: |
|
|
| Only U. S. Citizens or aliens who have a legal right to work in the U. S. are eligible for employment. Can you, upon employment provide genuine documentation establishing your identity and eligibility to be legally employed in the United States? |
|
Yes
No |
| Have you ever been convicted of a crime or violation other than a minor traffic infraction? |
|
Yes
No |
| A conviction record will not necessarily be a bar to employment factors such as job relations, age and time of the offense, seriousness and nature of violation and rehabilitation will be taken into account. |
If yes, please explain:
|
|
Must be completed even if resume is provided.
Begin with your most recent employment. |
Employer 1 |
| Name of Company: |
|
| Address: |
|
|
| City: |
|
State:
Zip Code:
|
| Type of Business: |
|
| From: (mm/yy)
|
| To: (mm/yy)
|
| Starting Salary:
|
| Ending Salary:
|
| Job Title: |
|
| Name & Title of Immediate Supervisor: |
|
Describe your job duties:
|
| Reason For Leaving: |
|
May we contact employer?:
Yes
No
|
|
| Employer 2 |
| Name of Company: |
|
| Address: |
|
|
| City: |
|
State:
Zip Code:
|
| Type of Business: |
|
| From: (mm/yy)
|
| To: (mm/yy)
|
| Starting Salary:
|
| Ending Salary:
|
| Job Title: |
|
| Name & Title of Immediate Supervisor: |
|
Describe your job duties:
|
| Reason For Leaving: |
|
May we contact employer?:
Yes
No
|
|
| High School |
| Name: |
|
City:  State: Zip Code: |
|
|
| Major Subject: |
|
| Last Year Attended:
9
10
11
12 |
| Did you graduate?
Yes
No |
|
| College |
| Name: |
|
| City: State: Zip Code: |
|
|
| Major Subject: |
|
| Last Year Attended:
1
2
3
4 |
| Did you graduate?
Yes
No |
| Degree:
|
|
| Graduate School |
| Name: |
|
| City: State: Zip Code: |
|
|
| Major Subject: |
|
| Last Year Attended:
1
2
3
4 |
| Did you graduate?
Yes
No |
| Degree:
|
|
| Business / Trade / Other |
| Name: |
|
| City: State: Zip Code: |
|
|
| Major Subject: |
|
| Last Year Attended:
1
2
3
4 |
| Did you graduate?
Yes
No |
| Degree:
|
|
Please list any other experience, skill or other qualifications including hobbies, which you believe should be considered in evaluating you qualifications for employment. Please indicate any prior military service which you would like considered in connection with your application for employment.
|
|
CDL Class:
Forklift
Other |
Explain:
|
|
|
|
|
Auburn Supply Notification and Agreement
I certify that all answers given by me are true, accurate, and complete, I understand that falsification, misrepresentation or omission of fact on this application (or any other accompanying or required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.
Electronic Signature |
