Greer Lingle Middle School Gymnasium

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Address*

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Are you a citizen of the United States?*

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Have you ever worked for this company?*

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If so, when?

Have you ever been convicted of a felony?*

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If yes, list dates, offenses, and disposition.

Convictions are not an automatic disqualification from employment.

Employment Interests

Date Available*

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Position Applied For

Desired Salary*

Education

High School

Address

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Dates Attended

From	To

Did you graduate?

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Degree

College

Address

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Dates Attended

From	To

Did you graduate?

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Degree

Other

Address

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Dates Attended

From	To

Did you graduate?

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Degree

References

Please list 3 professional references. (Click the + button to add a new row)

Full Name	Company	Relationship	Address	Phone

Employment History

Company Name (Most Recent)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Supervisor

Job Title

Salary (Hour/Week/Month)

Start	End

Responsibilities

Dates Employed

From	To

Reason for Leaving?

May we contact your previous employer for a reference?

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Did you have another job before this one?*

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Company Name (Second Most Recent)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Supervisor

Job Title

Salary (Hour/Week/Month)

Start	End

Responsibilities

Dates Employed

From	To

Reason for Leaving?

May we contact your previous employer for a reference?

Yes
No

Did you have another job before this one?

Yes
No

Company Name (Third Most Recent)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Supervisor

Job Title

Salary (Hour/Week/Month)

Start	End

Responsibilities

Dates Employed

From	To

Reason for Leaving?

May we contact your previous employer for a reference?

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Certifications

Please list:

Military Service

Have you ever served in the U.S. Armed Services?

Yes
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Branch

Dates of Service

Rank at Discharge

Type of Discharge

If other than honorable, explain

Disclaimer and Signature

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.

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Employment Interests

Education

References

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