SAGE INTERIOR DESIGN

Employment Application

APPLICANT INFORMATION
Last Name

Fraser

Street
Address

First

Dat
e
Apartment/Unit
#

Holden

M.I. R

8320 4th Street

City

Stonewood

State

Phone

304-625-1065

Date
12/30/15
Available
Position Applied
Sales Associate
for
Are you a citizen of the United
States?
Have you ever worked for this
company?
Have you ever been convicted of a
felony?

WV

ZIP

E-mail
Holdenfraser15@gmail.com
Address
Social Security
Desired
543-24-2523
No.
Salary

YES

NO

If no, are you authorized to work in the

U.S.?

YES

NO

If so, when?

YES

NO

If yes,
explain

Addres
s

One Eagle Way Clarksburg, WV 26301

YES

NO

Addres
s

N/A

YES

NO

Addres
s

N/A

YES

NO

Robert C Byrd High School

From

2012

Colleg
e

N/A

From

N/A

Other

N/A

From

N/A

To

To

To

2016

N/A

N/A

Did you
graduate?

Did you
graduate?

Did you
graduate?

Degree

Degree

N/A

Degree

N/A

REFERENCES
Please list three professional references.
Full Name

Steve Smith

Relationshi
p

Company

NASA

Phone

Address

375 7th Street Clarksburg, WV 26301

Full Name

N/A

Relationshi
p

Company

N/A

Phone

Address

N/A

Full Name

N/A

Relationshi
p

Company

N/A

Phone

Address

N/A

Friend

304-643-2347

N/A

N/A

N/A

N/A

N/A

26301

EDUCATION
High
School

12/18/2015

$9.00

YES

NO

PREVIOUS EMPLOYMENT
Company

Party City

Phone

Address

584 East Main Street Clarksburg, WV 26301

Superviso
r

Job Title

Sales Associate

Starting
Salary

Responsibilities

Cashier, Stocking shelves, and maintenance

From

To

2014

2015

Reason for Leaving

May we contact your previous supervisor for a

reference?

YES

Address

N/A

Superviso
r

Job Title

N/A

Starting
Salary

To

N/A

N/A

Reason for Leaving

May we contact your previous supervisor for a

reference?

YES

Address

N/A

Superviso
r

Job Title

N/A

Starting
Salary

To

N/A

N/A

Reason for Leaving

May we contact your previous supervisor for a

reference?

Ending
Salary

N/A

NO
Phone

From

N/A

N/A

N/A

N/A

N/A

Ending
Salary

N/A

N/A

Company

Responsibilities

$8.00

NO
Phone

From

Ending
Salary

N/A

N/A

N/A

Joe Kemp

$8.00

Company

Responsibilities

304-754-2355

N/A
N/A

N/A

N/A
YES

NO

MILITARY SERVICE
Branch

N/A

Rank at Discharge

From
N/A

If other than honorable,

explain

N/A

To

N/A

Type of Discharge

N/A

N/A

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