ABC Shoes Employment Application Form

Applicant Information

Full Name: ___________________________________________

Date of Application: __________________________________

Phone Number: ________________________________________

Email Address: _______________________________________

Current Address:
  _______________________________________________
  _______________________________________________
(Street, City, State, Zip)

Position Applied For

Position Title: ______________________________________

Desired Salary: ______________________________________

Date Available to Start: ______________________________

Availability (Check all that apply):

_______ Full-Time

_______ Part-Time

_______ Weekends

_______ Holidays

Education

| School Name          | Location     | Degree/Diploma   | Year Graduated |

|----------------------|------------------|-----------------------|----------------|

| ____________________ | ________________ | ____________________ | ______________ |

| ____________________ | ________________ | ____________________ | ______________ |

| ____________________ | ________________ | ____________________ | ______________ |

Employment History

*Please list your last three employers, starting with the most recent.*

1.

Employer Name: ___________________________________________

Location: ________________________________________________

Job Title: _______________________________________________

Dates of Employment: From _________ to __________

Reason for Leaving: _______________________________________

Responsibilities: _________________________________________

2.

Employer Name: ___________________________________________

Location: ________________________________________________

Job Title: _______________________________________________

Dates of Employment: From _________ to __________

Reason for Leaving: _______________________________________

Responsibilities: _________________________________________

3.

Employer Name: ___________________________________________

Location: ________________________________________________

Job Title: _______________________________________________

Dates of Employment: From _________ to __________

Reason for Leaving: _______________________________________

Responsibilities: _________________________________________

References

*Please list three professional references.*

1.

Name: __________________________________________

Relationship: __________________________________

Phone Number: __________________________________

Email: _________________________________________

2.

Name: __________________________________________

Relationship: __________________________________

Phone Number: __________________________________

Email: _________________________________________

3.

Name: __________________________________________

Relationship: __________________________________

Phone Number: __________________________________

Email: _________________________________________

Disclaimer and Signature

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that if this application leads to employment, any false or misleading information may result in my release.

Applicant Signature: __________________________________

Date: __________________________________