Long Employee Application Personal Info Full Name * First,Middle and Last Name Full Address * Address, Apt Number, City and State Phone Number * your Phone Number Email Address * Email Address Drivers License # Full drivers license number State Driver's License was issued the state you got your drivers license in Date Available the date you can start Desired Salary What is your desired pay? Desired Position AnyClericalCoin Laundry AttendantCall Center AgentMaintenance What position would you like to fill Are you a U.S. citizen? Yes No Were you born in the U.S. or otherwise naturalized? If No, are you able to legally work in the U.S.? Yes No Do you have a work Visa? Have you ever been convicted of a felony? Yes No Have you plead "guilty" or "no contest" to felony charges? If yes, explain Explain details of felony charges Reference Professional Reference First and last name of a professional refrence Relationship your relationship to this refrence Company The company this reference works for Reference Contact The phone number to contact this refrence Education History High School What high school did you go to? Did you graduate? Yes No Did you receive a diploma? College Name the college you went to Degree What was your course of study? Did you graduate? Yes No Did you receive a diploma? Any other education? List any other notable education here Employment History Previous Employer Name of your previous employer Phone Number Contact of previous employer Supervisor Name The name of your supervisor Address Address of previous employer Job Title Title of your previous position Starting Salary How much were you being paid when you started? Ending Salary How much were you getting paid when you left? Responsibilities List the responsibility of your last position Starting date What date did you start? Date left When did you leave the job? Reason for Leaving Why did you leave this position? Can we contact your previous employer? Yes No Employment History 2 Previous Employer Phone Number Address Supervisor Name Job Title Starting Salary Ending Salary Responsibilities Starting date Date left Reason for Leaving Why did you leave this position? Can we contact your previous employer? Yes No Why do you feel that you would be a good fit for this position? reCAPTCHA Email If you are human, leave this field blank.
