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Professional Business Associates
5454 Cleveland Avenue Columbus, OH 43231-4021 614-895-7277
EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER

Employment Application
The law prohibits discrimination because of age, race, color, gender, religion and national origin, and requires affirmative action in the hiring of minorities, women, the handicapped, and veterans.

PLEASE PRINT ALL INFORMATION IN BLACK OR BLUE INK.
BE SURE TO SIGN THIS APPLICATION ON THE LAST PAGE.
Last Name Jones Street Address 13 Fantan Are you 18 years of age or older? ______Yes First Name Jason City Billings __X___No ___X__Part-Time State MT

Middle Name ZIP Telephone Number

59105 (406) 555-1212 E-mail Address jjonesr@hotmail.com

Describe the type of employment you desire: What hours are you available to work:

______Full-Time

__Any hours possible____Weekend ____5 p.m. to 8 p.m.___ Weekday

Position Sought:___Human Resource Office Assistance___________________________________ When would you be available for employment? ____As soon as possible___________

Academic Training
Institution Name and Location Attended From To (Mo./Yr.) Major Subjects GPA Degree/Diploma Date Received or Expected

Skyview High School 1775 High Sierra Blvd. N/A

2007 to Present N/A

Physics, English 3, U.S. History, Algebra 2, Symphonic Winds, Spanish 2 N/A

3.8

N/A

2001

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

List Other Education, Professional Certification, Licensure, Accreditation
N/A

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Employment History
List your past three (3) jobs, activities, and/or other experience, including volunteer work, part-time employment while in school, U.S. Military Service, and self-employment. Employer (present or most recent) Subway Restaurant Street Address, City, State ZIP Supervisor (name and title) Ms. Brooke Clark Manager Your Job Title

4905 South Gate Drive, Billings, MT 59101 Sandwich Artist Description of your duties: Operate cash register, open and close store, prepare meats, vegetables, and bread, display positive customer service, and clean the facility Reason for leaving: N/A From (Mo./Yr.) May 2008 To (Mo./Yr.) Present

May we contact your present employer for references? May we contact you at your present place of employment?

___X___yes ___X___yes

______no ______no

If yes, please list employment telephone number ____(406) 254-7312___________________ Employer Hooligan’s Sports Bar & Grill Street Address, City, State ZIP 109 North 28 Street, Billings, MT 59101 Description of your duties: Wash and put away dishes and clean facility
th

Supervisor (name and title) Shane Clark Manager Your Job Title Hydrostatic Engineer

Reason for leaving: N/A

From (Mo./Yr.) November 2009

To (Mo./Yr.) Present

Employer N/A Street Address, City, State ZIP N/A Description of your duties:

Supervisor (name and title) N/A Your Job Title N/A

N/A Reason for leaving: N/A

From (Mo./Yr.) N/A

To (Mo./Yr.) N/A

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Achievements
Earned a professional certificate in Personal Finance course at Skyview High School. Became treasurer of Thespian Troupe, Drama Club, and Key Club. Maintained my current position for over 17 months. Received 9th place for Interview Skills at B.P.A. State in 2008.

References
List three (3) persons familiar with your work ability that we may contact. Exclude relatives. Name (Last, First) Clark, Brooke See, David Berry, Janelle Address (City, State ZIP) 212 South 33 Street, Billings, MT 59101 2 Cavalier Street, Billings, MT 59105 1316 Columbine Drive, Billings, MT 59105
rd

Telephone Number (406) 896-0902 (406) 534- 1766 (406) 256- 1598

U.S. Military Service
Service Branch:

N/A

Dates:

Specialty Training Received:

____N/A______________________________________________________________ __________________________________________________________________ __________________________________________________________________

Personal
Do you have the legal right to work in the U.S.? Have you ever been convicted under your current name or any other name of a felony?

X

Yes Yes

No

X

No

If yes, give date, court, nature of offense, and disposition: _____N/A_____________________________________________ I certify that the answers I have given to the foregoing questions and statements are true and correct, without mental reservation of any kind. If employment is obtained under this application, I will comply with all orders, rules and regulations of the company. I agree to submit to a physical examination. I also authorize my former employers and educational institutions to give any information they may have regarding me. I release them and their organizations from all liability for any damage whatsoever for issuing same. If, upon investigation, anything in this application is found to be untrue, I understand that I will be subject to dismissal at any time during the period of my employment.

Applicant — please sign and date here ______33-0062-0060____1-30-11______________
Signature Date

If electronic signature is unavailable, please check here __X____ to signify agreement and type applicant’s initials here __TBN__.