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PERSONAL INFORMATION
MI
Are you less than 18 years of age?
Other names you are known by
Are you legally eligible for employment in the U.S.?
(U.S. proof of citizenship or immigration
status will be required if hired for a position in the U.S.)
Have you been convicted of a felony in the last seven years?
(Arrests are not convictions. A conviction will not
necessarily disqualify you for employment.)
Present Address
Street
City
Zip Code
Permanent Address
Same
as present address
Phone Number(s) and Email Address (Please
include phone number area code.)
Evening
EMPLOYMENT DESIRED (If
you are applying for an hourly position, please keep in mind that the
availability of hours may vary.)
Location
Salary Desired
(Please enter in MM/DD/YYYY)
Are you able to work overtime?
EDUCATION
High School
Name of school
Address
Number of years completed
Did you graduate?
College: Undergraduate
Name of school
Address
Number of years completed
Did you graduate?
Subjects studied/degrees received
College: Graduate School
Name of school
Address
Number of years completed
Did you graduate?
Subjects studied/degrees received
Trade, Business, or Correspondence School
Name of school
Address
Number of years completed
Did you graduate?
Subjects studied/degrees received
SKILLS
List skills relevant to the position applied for
For Office/Administrative positions only
Typing WPM
10-Key
Computer proficiency: MS Word?
Excel?
Other computer programs:
FORMER EMPLOYERS
List below current and last three employers, starting with the most
recent first. Please include any non-paid/volunteer experience which
is related to the job for which you are applying.
Current Employer
Dates employed (Please enter in MM/YYYY)
From
To
Employer's name
Employer's address
Type of business
Position
Salary or Hourly?
Starting
Ending
Duties performed
Reason for leaving
Supervisor's name
Phone number
May we contact your supervisor?
Previous Employer
Dates employed (Please enter in MM/YYYY)
From
To
Employer's name
Employer's address
Type of business
Position
Salary or Hourly?
Starting
Ending
Duties performed
Reason for leaving
Supervisor's name
Phone number
May we contact your supervisor?
Previous Employer
Dates employed (Please enter in MM/YYYY)
From
To
Employer's name
Employer's address
Type of business
Position
Salary or Hourly?
Starting
Ending
Duties performed
Reason for leaving
Supervisor's name
Phone number
May we contact your supervisor?
Previous Employer
Dates employed (Please enter in MM/YYYY)
From
To
Employer's name
Employer's address
Type of business
Position
Salary or Hourly?
Starting
Ending
Duties performed
Reason for leaving
Supervisor's name
Phone number
May we contact your supervisor?
REFERENCES
Please give the names of at least three professional references,
whom you have known at least one year.
- Name
Phone number
- Name
Phone number
- Name
Phone number
- Name
Phone number
I hereby authorize RMMSO to thoroughly investigate my background,
references, employment record and other matters related to my
suitability for employment. I authorize persons, schools, my current
employer (if applicable), and previous employers and organizations
contacted by RMMSO to provide such information regarding my current
and/or previous employment and I release all persons, schools,
employers of any and all claims for providing such information. I
understand that misrepresentation or omission of facts may
result in rejection of this application, or if hired, discipline up to
and including dismissal. I understand that nothing contained in the
application, or conveyed during any interview which may be granted, is
intended to create an employment contract. I understand that filling
out this form does not indicate there is a position open and does not
obligate RMMSO to hire me. (U.S. APPLICANTS ONLY I understand and
agree that my employment is at will, which means that it is for no
specified period and may be terminated by RMMSO or me at any time
without prior notice for any reason.)
I Accept Date
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