APPLICATION FOR EMPLOYMENT

We are an equal opportunity employer, dedicated to a policy of nondiscrimination in employment
on any basis including race, color, age, sex, religion, disability, or national origin.
APPLICANT INFORMATION
Last Name

Garcia

Street Address

First

M.I.

1762 ACACIA AVE

City

Sanger

Phone
(s)

559-288-4500

Date Available

Dat
e
Apartment/Unit
#

Julia

State
E-mail
Address
Last four
digits of SSN

5-15-16

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

YES

NO

YES

NO

Are you employed now?

YES

NO

Type of Employment

Full-time

California

ZIP

K

3-14-16
     

93657

juliasmith@gmail.com
XXX – XX– 123

Desired Salary

If no, are you authorized to work in the
U.S.?
If so,
     
when?
If so, may we contact your employer?
Part-time

Summer

$2,000

YES

NO

YES

NO

Temporary

EDUCATION AND OFFICE SKILLS
High
School

Sanger high school

From

201
3

College
or Trade
School

N/A

From

N/A

Years of Typing
Experience

To

To

2016

Did you
graduate?

N/A

5

Computer Software and
Hardware Experience

Did you
graduate?

Words Per
Minute

100

Address

1045 bethel ave

YES

NO

Address

N/A

YES

NO

Other Office
Equipment
Used

     

Degree
Printer

Copier

     

Phone

Address

     

Name and
Position of
Supervisor

Job Title

     

Starting
Salary

From

To

     

     

Reason for Leaving

May we contact your previous supervisor for a
reference?

WFSCT (09-20-2010)

Scanner

Calculator

(LIST PRESENT OR MOST RECENT POSITIONS

Compan
y

     

Fax

none

EMPLOYMENT HISTORY
FIRST)

Responsibilities

     

     
     
Ending
Salary

$     

     
YES

NO

     

$     

EMPLOYMENT HISTORY

(CONTINUED)

Compan
y

     

Phone

Address

     

Name and
Position of
Supervisor

Job Title

     

Starting
Salary

Responsibilities

     

From

To

     

     

Reason for Leaving

May we contact your previous supervisor for a
reference?
Compan
     
y
Address

     

Job Title

     

From

To

     

YES

Reason for Leaving

May we contact your previous supervisor for a
reference?
Compan
     
y
Address

     

Job Title

     

From

To

     

YES

Reason for Leaving

May we contact your previous supervisor for a
reference?

$     

     

Phone

     

Ending
Salary

$     

Ending
Salary

$     

     

$     

     

Starting
Salary
     

     

NO

NO

     

Phone

     

Name and
Position of
Supervisor

Responsibilities

Ending
Salary

     

Starting
Salary
     

     

$     

Name and
Position of
Supervisor

Responsibilities
     

     

     

$     

     
YES

NO

     

MILITARY SERVICE
Branch

     

Rank at Discharge

From
     

If other than honorable,
explain

     

Type of Discharge

To

     

     

     

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.
Signatur
e

WFSCT (09-20-2010)

Date