Name
Address 1
Address 2
City/St/Zip
E-mail 1
544 West Street
Work Phone
Cell Phone
Personal Information
D.O.B.
(___) ___-____
Cell Carrier
TXT.ATT.NET
OK to Text? $
E-mail 2
SSN
Alternate #
Pager #
Emergency #
Emergency Contact
Emergency Address
Driver's License #
Did you server in the military?
Where you honorably discharged?
If no, explain why not
Have you ever been convicted of a felony?
(Conviction is not automatic bar to employment)
If yes, what were you convicted for?
How did you hear about us?
(___) ___-____
Employee Referral
(330) 254-3961
Education
Type of School
Name and Location
School
City/State
School
City/State
Herzing University
From/To
Grad Year
10/11
Online, WI
GPA/
Out of
09/13
Computer Sciences
09/13
4
05/09
Wadsworth High School
Major
4
08/05
Wadsworth, OH
School
City/State
Employment Preference
Position Desired
Location Preferred
Salary Desired
Minimum Hourly
7.85
Can we call you at work?
Preferences
Available to travel?
Willing to relocate?
Willing to Commute?
How Long?
Work Temp?
Reliable transportation? $
Smoking OK? $
First date available to work?
Days available
Career Objectives
Mon
Tues
Weds
Thurs
Fri
Sat
Sun
List employment history for the last 3 employers, starting with most recent employment.
Employer
Bob Evans
Phone Number
Address
City/State/Zip
Supervisor
From Date
Responsibilities
Reason for Leaving
03/15/2013
Salary
Chris
Hourly?
Last Raise Date
Industry
Sales
Service Attendant
Take customer orders, answer phone, run cash register, run food.
Allergic to a cleaner and decided to focus on school.
Employer
Phone Number
Address
Employment History
3.7
Commission/Bonus
May we use this employer as a reference?
Title
08/01/2008
To Date
Medina, OH
Phone Number
Position
(330) 725-1348
From Date
City/State/Zip
To Date
Supervisor
Salary
Phone Number
Commission/Bonus
May we use this employer as a reference?
Position
Hourly?
Last Raise Date
Industry
Title
Responsibilities
Reason for Leaving