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Includes sections for employment desired, availability, education background, skills and activities, licenses, military service, and emergency contact details. Provides prompts for driver’s license status, U.S. citizenship, felony convictions, and willingness to submit to pre-employment drug screening. 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Yes  No |  |\n| Email Address: |  |  |  |  |  |  |  |  |\n| Do you currently Obtain a valid\u003Cbr>Drivers License? |  |  | If yes\u003Cbr>what state? |  | License \\# |  |  |  |\n| Are You A U.S. Citizen? |  |  |  | Have You Ever Been Convicted Of A Felony? |  |  |  |  |\n| Yes No |  |  |  | Yes No |  |  |  |  |\n| If Selected For Employment Are You Willing To Submit to a Pre-Employment Drug Screening Test? |  |  |  |  |  |  |  |  |\n| Yes No |  |  |  |  |  |  |  |  |\n| In Case of an Emergancy Contact Info |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |\n| Name: |  | Address: |  |  |  |  | Phone \\# |  |\n|  |  |  |  |  |  |  |  |  |\n| Employment Desired |  |  |  |  |  |  |  |  |\n|  |  |  |  | Desired Pay: |  |  | Employment Desired: | |\n| Position: |  |  |  | Available Starte Date: |  |  |  |  |\n| Are you currently\u003Cbr>employed and Where? |  |  |  |  |  | If yes may we contact your\u003Cbr>current employer? |  |  |\n| Refered By: |  |  |  |  |  |  |  |  |\n| Education |  |  |  |  |  |  |  |  |\n| School Name |  |  |  | Location |  | Years Attended | Did you\u003Cbr>Graduate? | Major |\n| High School: |  |  |  |  |  |  |  |  |\n| College: |  |  |  |  |  |  |  |  |\n| Trade School: |  |  |  |  |  |  |  |  |\n| U.S Military or\u003Cbr>Naval Service? |  | Rank: |  |  | Are you an active\u003Cbr>Nation Guard or Reserve? |  |  |  |\n| General |  |  |  |  |  |  |  |  |\n| Skills: |  |  |  |  |  |  |  |  |\n| Activities:(Civic, Athletic, Etc.) |  |  |  |  |  |  |  |  |\n| CDL License? |  | Class A |  | Class B |  | License \\# |  |  |\n\n(Continue on back side)  \n\n| Employment History |  |  |  |  | Date:\u003Cbr>(Month and Year) |  |\n| --- | --- | --- | --- | --- | --- | --- |\n|  |  |  |  |  | From |  |\n| Employer (1) |  |  | Job Title |  | To |  |\n| Work Phone: |  | Salary/ Ending Pay Per Hour: |  |  |  |  |\n| Reason for leaving: |  |  |  |  | Location: (City & State) |  |\n|  |  |  |  |  | From |  |\n| Employer (2) |  |  | Job Title |  | To |  |\n| Work Phone: |  | Salary/ Ending Pay Per Hour: |  |  |  |  |\n| Reason for leaving: |  |  |  |  | Location: (City & State) |  |\n|  |  |  |  |  | From |  |\n| Employer (3) |  |  | Job Title |  | To |  |\n| Work Phone: |  | Salary/ Ending Pay Per Hour: |  |  |  |  |\n| Reason for leaving: |  |  |  |  | Location: (City & State) |  |\n| References |  |  |  |  |  |  |\n| Give 3 persons not related to you, whom you have known for no less then 1 year. |  |  |  |  |  |  |\n| Name |  | Phone \\# |  | Company |  | Years Acqyainted |\n|  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |\n| Authorization and Understanding: |  |  |  |  |  |  |\n| Upon the signing of this application, I represent that all of the information now or hereafter given by me in support of my application for employment is true and complete. I authorize you to verify any of the information concerning my employment, education, driving record, criminal history/background check, credit history, or medical history with the appropriate individuals , companies, institutions or agencies and I authorize them to release such information as you require, including my prior disciplinary employment record, without any obligation to give me written notice of such disclosure. I hereby release you and them from any liability whatsoever as a result of any such inquiries and disclosures. I agree that any false information in support of my application may subject me to discharge at any time during the period of my employment. If hired, I agree I will serve at the will of Spencer County So","cbCaia7cGjAv4EWu","https://ap.wps.com/l/cbCaia7cGjAv4EWu","pdf",28413,"English","# Personal Information\n## Employment Desired\n## Education\n## Skills and Licenses\n## Employment History\n## References\n## Authorization and Understanding\n## Signature and Office Use","[{\"question\":\"What personal information does this employment application collect?\",\"answer\":\"It requests name, address, phone numbers, email, date, and identity details such as SS#, plus emergency contact information.\"},{\"question\":\"What eligibility and compliance questions are included?\",\"answer\":\"The form asks whether the applicant is 18 or older, a U.S. citizen, whether they have been convicted of a felony, whether they hold a valid driver’s license, and whether they will submit to a pre-employment drug screening test.\"},{\"question\":\"What authorization does the applicant provide when signing?\",\"answer\":\"The applicant authorizes the employer to verify employment, education, driving record, criminal history/background check, credit history, and medical history, and to receive prior disciplinary employment records; the applicant also agrees that false information may lead to discharge.\"}]","Employment-Application-2020 - Pre-Employment Questionnaire - Equal Opportunity Employer | PDF",1789766571]