Creative Touch - New Hire

ALL POTENTIAL EMPLOYEES ARE EVALUATED WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER, NATIONAL ORIGIN, AGE, MARITAL OR VETERAN STATUS, THE PRESENCE OF A NON-JOB RELATED HANDICAP OR ANY OTHER LEGALLY PROTECTED STATUS.

Job Application

First Name : *

Middle Name :

Last Name : *

Position Sought : *

How did you learn about the position?

Country: *

Street Address *

Suite

Zip Code *

State

City

Home Phone

Cell Phone *

Other Phone

E-mail Address *

Social Security Number *

On what date would you be available for work? *

Desired Wage/Salary $ *

Are you a U.S. citizen, or are you otherwise authorized to work in the U.S. without any restriction? *
Yes No

If no, please describe:

Have you ever been convicted of a criminal offense other than minor traffic violations? *
Yes No

If yes, please describe circumstances:

Please provide only for positions that require driving:

Do you have a valid driver’s license?
Yes No

Please enter your first, middle, and last name exactly as it appears on you DMV photo document.

First name

Middle name

Last name

Driver’s license number

State

Have you ever been involuntarily terminated or asked to resign from any position of employment? *
Yes No

If yes, please describe circumstances:

If selected for employment, are you willing to submit to a pre-employment drug screening test and a criminal background investigation? *
Yes No

EDUCATION

1.SCHOOL

School Name

Location

Years Attended

Degree Received

Major

2.SCHOOL

School Name

Location

Years Attended

Degree Received

Major

3.SCHOOL

School Name

Location

Years Attended

Degree Received

Major

Other training, certifications, or licenses held:

List other information pertinent to the employment you are seeking:

EMPLOYMENT REFERENCES (Most Recent First)

1. Employer:

Job Title:

Dates Employed:

Prior Position Held within Company (if any):

Address:

City:

State:

Zip:

Phone:

Job Title:

Supervisor:

Starting Salary:

Ending Salary:

Duties Performed:

Reason for Leaving:

2. Employer:

Job Title:

Dates Employed:

Prior Position Held within Company (if any):

Address:

City:

State:

Zip:

Phone:

Job Title:

Supervisor:

Starting Salary:

Ending Salary:

Duties Performed:

Reason for Leaving:

3. Employer:

Job Title:

Dates Employed:

Prior Position Held within Company (if any):

Address:

City:

State:

Zip:

Phone:

Job Title:

Supervisor:

Starting Salary:

Ending Salary:

Duties Performed:

Reason for Leaving:

REFERENCES

1. Name:

Company Name:

Job Title:

Address:

City:

State:

Phone Number:

Email:

Relationship to you:

2. Name:

Company Name:

Job Title:

Address:

City:

State:

Phone Number:

Email:

Relationship to you:

3. Name:

Company Name:

Job Title:

Address:

City:

State:

Phone Number:

Email:

Relationship to you: