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US Lighting

 

Employment Application

Personal Information
NAME (LAST NAME FIRST) SOCIAL SECURITY
PRESENT ADDRESS CITY
STATE ZIP CODE
PERMANENT ADDRESS CITY
STATE ZIP CODE
PHONE NUMBER REFERRED BY

Employment Desired
POSITION DATE YOU CAN START
SALARY DESIRED ARE YOU EMPLOYED? YES NO
EVER APPLIED TO THIS COMPANY BEFORE? YES NO  
WHERE? WHEN?

Education History
NAME & LOCATION OF SCHOOL
YEARS ATTENDED
DID YOU GRADUATE
GRAMMAR SCHOOL
GRAMMAR SCHOOL SUBJECTS STUDIED
HIGH SCHOOL
HIGH SCHOOL SUBJECTS STUDIED
COLLEGE
COLLEGE SUBJECTS STUDIED
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL SUBJECTS STUDIED

General Information
SUBJECTS OF SPECIAL STUDY/RESEARCH SKILLS
U.S. MLITARY OR NAVAL SERVICE RANK

Former Employers

Date
Month and year

Name & Address of Employer Salary Position
From:
To:
Reason for leaving:

From:

To:

Reason for leaving:


From:
To:
Reason for leaving:

References
Name Address Business Years Known

Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shal be grounds for dissmisal.

I authorize investigation of all statements contained hereinand the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no reporesentative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.

Date  
Initial Here