Highland
Area Chamber of Commerce -
Employment
Application Form
PERSONAL
INFORMATION:
First
Name _____________________________
Middle
Name ___________________________
Last Name
_____________________________
Street
Address
_______________________________________________________
City,
State, Zip Code
_______________________________________________________
Phone
Number
(___)___________________________________
Are you
eligible to work in the United States?
Yes _______
No_______
If you
are under age 18, do you have an employment/age certificates?
Yes ___
No ___
Have you
been convicted of or pleaded no contest to a felony.
Yes_______
No_______
If yes,
please explain: _______________________________________________
_________________________________________________________________
POSITION/AVAILABILITY:
Position
Applied For
________________________________________
What date
are you available to start work?
________________________________________
EDUCATION:
Name and
Address Of School - Degree/Diploma - Graduation Date
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Skills
and Qualifications: Licenses, Skills, Training, Awards
_________________________________________________________________
_________________________________________________________________
EMPLOYMENT
HISTORY:
Present
Or Last Position:
Employer:
_____________________________________________________
Address:______________________________________________________
Supervisor:
____________________________________________________
Phone:
_______________________________
Email:
________________________________
Position
Title: _________________________
From:
______________ To: ______________
Responsibilities:
_____________________________________________
_________________________________________________________________
Salary:
_______________
Reason
for Leaving: ____________________________________________
===========
Previous
Position:
Employer:
_____________________________________________________
Address:______________________________________________________
Supervisor:
____________________________________________________
Phone:
_______________________________
Email:
________________________________
Position
Title: _________________________
From:
______________ To: ______________
Responsibilities:
____________________________________________
_________________________________________________________________
Salary:
_______________
Reason
for Leaving: _________________________________________
Previous
Position:
Employer:
_____________________________________________________
Address:______________________________________________________
Supervisor:
____________________________________________________
Phone:
_______________________________
Email:
________________________________
Position
Title: _________________________
From:
______________ To: ______________
Responsibilities:
_____________________________________________
_________________________________________________________________
Salary:
_______________
Reason
for Leaving: ____________________________________________
Previous
Position:
Employer:
_____________________________________________________
Address:______________________________________________________
Supervisor:
____________________________________________________
Phone:
_______________________________
Email:
________________________________
Position
Title: _________________________
From:
______________ To: ______________
Responsibilities:
_____________________________________________
_________________________________________________________________
Salary:
_______________
Reason
for Leaving: ____________________________________________
May We
Contact Your Present Employer?
May We Contact Your Past Employers?
Yes _____
No _____
Yes _____ No _____
References:
Name/Title Address Phone
1)________________________________________
2)________________________________________
3)________________________________________
4)________________________________________
I certify
that information contained in this application
is true and complete.
I understand that false information may be grounds for not
hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification
of any or all information listed above.
Signature______________________________
Date__________________________________
Please
complete this application, copy and paste it and email to highlandchamber@yahoo.com along with all requested documents requested in the job description.
