Clark Enterprises Inc356 Old Rt 8, Grove City, Pennsylvania 16127(814)-786-7952[email protected]
Employment Application
PERSONAL INFORMATION
FULL NAME: DATE : ADDRESS: CITY: STATE: ZIP CODE: PHONE: EMAIL: SOCIAL SECURITY NUMBER (SSN): - - DATE AVAILABLE: POSTION APPLIED FOR: EMPLOYMENT DESIRED: ☐ FULL-TIME ☐ PART-TIME ☐ TEMPORARY
EMPLOYMENT ELIGIBILITY
ARE YOU A U.S. CITIZEN? ☐ YES ☐ NO**IF NO, ARE YOU ALLOWED TO WORK IN THE U.S.? ☐ YES ☐ NOHAVE YOU BEEN CONVICTED OF A FELONY? ☐ YES ☐ NO* *IF YES, PLEASE EXPLAIN:
EDUCATION
HIGH SCHOOL: CITY/STATE: FROM: TO: GRADUATE: ☐ YES ☐ NODIPLOMA: COLLEGE: CITY/STATE: FROM: TO: GRADUATE: ☐ YES ☐ NODEGREE: OTHER: CITY/STATE: FROM: TO:
EMPLOYMENT HISTORY
EMPLOYER #1: PHONE: ADDRESS: CITY: STATE: ZIP CODE: JOB TITLE: SALARY: RESPONSIBILITES: REASON FOR LEAVING:
EMPLOYER #2: PHONE: ADDRESS: CITY: STATE: ZIP CODE: JOB TITLE: SALARY: RESPONSIBILITES: REASON FOR LEAVING:
EMPLOYER #3: PHONE: ADDRESS: CITY: STATE: ZIP CODE: JOB TITLE: SALARY: RESPONSIBILITES: REASON FOR LEAVING:
MILITARY SERVICE ARE YOU A VETERAN? ☐ YES ☐ NOBRANCH: STARTING DATE: ENDING DATE:
BACKGROUND CHECK CONSENT
IF ASKED, ARE YOU WILLING TO CONSENT TO A BACKGROUND CHECK? ☐ YES ☐ NO
DISCLAIMER
Applicant understands that this is an Equal Opportunity Employer and committed to excellence through diversity. In order to ensure this application is acceptable, please print or type with the application being fully completed in order to be considered.
I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.
SIGNATURE: DATE: PRINT NAME:
PERSONAL INFORMATION
FULL NAME: DATE : ADDRESS: CITY: STATE: ZIP CODE: PHONE: EMAIL: SOCIAL SECURITY NUMBER (SSN): - - DATE AVAILABLE: POSTION APPLIED FOR: EMPLOYMENT DESIRED: ☐ FULL-TIME ☐ PART-TIME ☐ TEMPORARY
EMPLOYMENT ELIGIBILITY
ARE YOU A U.S. CITIZEN? ☐ YES ☐ NO**IF NO, ARE YOU ALLOWED TO WORK IN THE U.S.? ☐ YES ☐ NOHAVE YOU BEEN CONVICTED OF A FELONY? ☐ YES ☐ NO* *IF YES, PLEASE EXPLAIN:
EDUCATION
HIGH SCHOOL: CITY/STATE: FROM: TO: GRADUATE: ☐ YES ☐ NODIPLOMA: COLLEGE: CITY/STATE: FROM: TO: GRADUATE: ☐ YES ☐ NODEGREE: OTHER: CITY/STATE: FROM: TO:
EMPLOYMENT HISTORY
EMPLOYER #1: PHONE: ADDRESS: CITY: STATE: ZIP CODE: JOB TITLE: SALARY: RESPONSIBILITES: REASON FOR LEAVING:
EMPLOYER #2: PHONE: ADDRESS: CITY: STATE: ZIP CODE: JOB TITLE: SALARY: RESPONSIBILITES: REASON FOR LEAVING:
EMPLOYER #3: PHONE: ADDRESS: CITY: STATE: ZIP CODE: JOB TITLE: SALARY: RESPONSIBILITES: REASON FOR LEAVING:
MILITARY SERVICE ARE YOU A VETERAN? ☐ YES ☐ NOBRANCH: STARTING DATE: ENDING DATE:
BACKGROUND CHECK CONSENT
IF ASKED, ARE YOU WILLING TO CONSENT TO A BACKGROUND CHECK? ☐ YES ☐ NO
DISCLAIMER
Applicant understands that this is an Equal Opportunity Employer and committed to excellence through diversity. In order to ensure this application is acceptable, please print or type with the application being fully completed in order to be considered.
I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.
SIGNATURE: DATE: PRINT NAME: