Visual Paper Products

Employment Application
Applicant Information
Full Name:

DOB:
Last

First

M.I.

Address:
Street Address

Apartment/Unit #

City

State

Phone:

ZIP Code

Email

Date Available:

S.S. No.:

Desired Salary:$

Position Applied for:

Are you a citizen of the United States?
Have you ever worked for this company?

YES

NO

YES

NO

If no, are you authorized to work in the U.S.?

If yes, when?
Please circle Job applied for:

Have you ever been convicted of a felony?

YES

Seasonal, Part-time, Full-time

NO

If yes, explain:

Education
High School:
From:

Address:
To:

Did you graduate?

College:
From:

NO

YES

NO

YES

NO

Diploma::

Address:
To:

Did you graduate?

Other:
From:

YES

Degree:

Address:
To:

Did you graduate?

Degree:

References
Please list three professional references.
Full Name:

Relationship:

Company:

Phone:
1

YES

NO

Address:
Full Name:

Relationship:

Company:

Phone:

Address:
Full Name:

Relationship:

Company:

Phone:

Address:

Previous Employment
Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Volunteer Service
Company

From:

Types of Duties:

To:

How often:

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.
Signature:

Date:
2