Employee Application

Application For Employment

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POSITION(S) APPLIED FOR
First Name
Last Name
Street Address
City
State
Zip Code
Telephone
Email
If you are under 18, can you furnish a work permit?	Yes No
Have you ever filed an application here before?	Yes No
Have you ever been employed here before?	Yes No
Are you legally eligible for employment in this country?	Yes No
(Proof of U.S. citizenship or immigration status will be required upon employment.)
Type of employment desired	Full-Time Part-Time Temporary (Seasonal, Internship, etc.)
Drivers License # / State
EMPLOYMENT HISTORY: List your last three (3) employers, assignments or volunteer activities starting with the most recent, include military experience.
Dates: From / To
Employer
Employer Address
Employer Phone
Job Title At Job
Immediate Supervisor and Title
Summarize the nature of work performed and job responsibilities
Rate of Pay Per Hour
Reason For Leaving
May We Contact?	Yes No
Employment History 2
Dates: From / To
Employer
Employer Address
Employer Phone
Job Title At Job
Immediate Supervisor and Title
Summarize the nature of work performed and job responsibilities
Rate of Pay Per Hour
Reason For Leaving
May We Contact?	Yes No
SKILLS AND QUALIFICATIONS Summarize special skills and qualifications acquired from employment or other experiences that may qualify your for work with WESTCO.
Fill in Here
EDUCATIONAL BACKGROUND
High School / Graduate Year
College / Graduate Year / Studied
Other
References
Name / Number
Name / Number
It is understood and agreed that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employers service if I have been employed. Furthermore, I understand that just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary.
I give the Employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the Employer and its representative for seeking such information and all other persons, corporations or organizations for furnishing such information.
Signature of Applicant (Electronic Verification)
Date
* Required field