Employment Application |
Applicant Information
Application Date: (mm / dd / yyyy)
Last Name:
First Name:
M.I.
Street Address:
Apartment/Unit#:
City:
State:
Zip Code:
Phone Number:
Email Address:
Date Available:
Position Desired: Full Time Part Time Full or Part Time
Salary Desired:
Position Applying For:
Are you a citizen of the United States? Yes No
- If no, are you authorized to work in the US? Yes No
Have you ever worked for this company? Yes No
- If yes, when?
Have you ever worked for a Florist? Yes No
- If yes, where and for how long?
Have you been convicted of a felony? Yes No
- If yes, please explain:
Education
High School:
Address:
From: To: Did you Graduate? Yes No
Degree:
College:
From: To: Did you graduate? Yes No
Other:
References
Please list three professional references:
Full Name:
Relationship:
Company:
Phone:
Previous Employment
Supervisor:
Job Title:
Starting Salary:
Ending Salary:
Responsibilities:
From:
To:
Reason For Leaving:
May we contact your previous supervisor for a reference? Yes No
Military Service
Branch:
Rank at Discharge:
Type of Discharge:
- If other than Honorable, explain:
Disclaimer and Submission
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I authorize investigation of all statements contained on this application and included resume. I further authorize you to contact my references and previous employers to verify the information contained herein.
Wesley Berry Flowers is an Equal Opportunity Employer.
