GRAHAM JOB APPLICATION
Please complete each line of the application.
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Date *
Last Name *
First Name *
Middle Name *
Present Address *
(Number Street, City, State Zip Code)
How long have you lived at this address? *
Enter number of years.
Telephone Number *
If under 18, please list age.
Email Address *
Position applied for *
Days/Hours Available to Work *
How many hours can you work weekly? *
Can you work weekends? *
Can you work evenings? *
Salary Desired *
Employment Desired *
What date are you available to start work? *
EDUCATION *
Type in the name of your HIGH SCHOOL, Address, Years Completed, and Degree.
EDUCATION *
Type in the name of your College/Business/Trade School, Address, Years Completed, and Degree.
WORK EXPERIENCE *
Type the name of your last employer.
Address of Last employer. *
Include Address, City, State, and Zip Code.
Phone number of last employer. *
Name of Last Supervisor *
Pay or Salary *
Employment Dates
Enter the START date for last employer.
MM
/
DD
/
YYYY
Employment Dates
Enter the END date for last employer.
MM
/
DD
/
YYYY
What was your last job title? *
Reason for leaving. *
Be specific.
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company. *
Are you currently employed? *
May we contact your previous employer? *
Did you complete this application yourself? *
If you did not complete application yourself, who did?
Have you ever been convicted of a felony? *
If yes, explain number of convictions, nature of offenses leading to conviction, how recently such offense was/were committed, sentence imposed, and types of rehabilitation.
Have you ever been in the armed forces? *
If hired, can you provide proof of US citizenship or proof of your legal right to live and work in the country? *
Have you ever been employed with this company? *
If yes, when?
Do you have any friends or family employed by this company? *
If yes, please provide their names and relationships to you.
If hired, would you have a reliable means of transportation to and from work? *
Are you able to perform the essential functions and duties of the job for which you are applying? *
If not, please describe the functions or duties you are unable to perform:
REFERENCE #1 Name *
Please list a reference not related to you who has the knowledge of your work performance and/or personal qualifications within the last 5 years.
*
Occupation
*
Company Name
*
Address
*
Telephone
*
Email
*
Number of Year Acquainted
REFERENCE #2 Name *
Please list a reference not related to you who has the knowledge of your work performance and/or personal qualifications within the last 5 years.
*
Occupation
*
Company Name
*
Address
*
Telephone
*
Email
*
Number of Year Acquainted
REFERENCE #3 Name *
Please list a reference not related to you who has the knowledge of your work performance and/or personal qualifications within the last 5 years.
*
Occupation
*
Company Name
*
Address
*
Telephone
*
Email
*
Number of Year Acquainted
Application Form Waiver - Please read each paragraph carefully and INITIAL under each one. *
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I have personally completed this application. I understand that any omission or misstatement of material fact on this application or any other document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
Application Form Waiver - Please read each paragraph carefully and INITIAL under each one. *
I hereby authorize this company to thoroughly investigate my references, work records, education, driving record, credit history, criminal background and other matters related to my suitability for employment. I further authorize the employers, schools and other references I have listed to disclose to this company any and all documents, transcripts, letters, reports, and other information related to these references, without giving me prior notice of such disclosure. I hereby release this company, my former employers, and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosures.
Application Form Waiver - Please read each paragraph carefully and INITIAL under each one. *
I understand that nothing contained in the application or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and this company, other than one that is "at will". I understand and agree that, if I am employed, my employment will be that of an "at will" nature, whereby either the employee or the employer may terminate the employment relationship at any time, with or without cause or notice. I further understand that my employment, if hired, is for no definite or determinable period of time and may be terminated at any time, at the option of either myself or the company, and that no promise or representation contrary to the foregoing is binding on the company unless made in writing and signed by me and the company's designated representative.
Signature of Applicant *
By typing your full name below, I understand that I am submitting my application for employment.
Date *
MM
/
DD
/
YYYY
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