Information

Full Name: Skaff kasey J Date: 10/11

Last First M.I.
Address: 6039 Matisse Lane
Street Address Apartment/Unit #
Roanoke VA 24018
City State ZIP Code
Phone: (540) 5886261 E-mail Address: Kaseyjane201@gmail.com

Date Available: 10/12 Social Security No.: 123-45-6789 Desired Salary: $35.50

Position Applied for: Marketing executive

YES NO YES NO
Are you a citizen of the United States? X If no, are you authorized to work in the U.S.?
YES NO
Have you ever worked for this company? x If yes, when?
YES NO
Have you ever been convicted of a felony? x

If yes, explain:

Education
High School: Cave Spring High School Address: 3712 Chaparrel Drive
YES NO
From: 2015 To: 2019 Did you graduate? X Degree: Advanced Diploma

College: West Virginia University Address:

YES NO
From: 2019 To: 2023 Did you graduate? X Degree: Marketing, Journalism

Other: Address:
YES NO
From: To: Did you graduate? Degree:

References
Please list three professional references.

Full Name: Meredith Shuman Relationship: Teacher

Company: Cave Spring High School Phone: (540)7727550

Address:

Full Name: Erin Relationship: Manager

Company: Zoes Kitchen Phone: (434)942-3553

Address:

Full Name: Lynn Hampton Relationship: Dance teacher

Company: Ardell Stone School of Dance Phone: (540) 123-4567

Address:
Previous Employment
Company: Zoes Kitchen Phone: (540) 623-5467

Address: 1234 Highway Lane Supervisor: Erin

Job Title: Hostess/server Starting Salary: $8.50 Ending Salary:

Responsibilities: Clean dining room, serve food, work register,

From: May 2017 To: Reason for Leaving: Currently employed

YES NO
May we contact your previous supervisor for a reference? X

Company: Target Phone: (540) 623-3894

Address: 4759 West Drive Supervisor: Bob four

Job Title: Cashier Starting Salary: $11.00 Ending Salary: $15.50

Responsibilities: Check people out in check out line

January
From: 2017 To: May 2019 Reason for Leaving: Other Oppurtunities
YES NO
May we contact your previous supervisor for a reference?

Company: Phone: ()

Address: Supervisor:

Job Title: Starting Salary: $ Ending Salary: $

Responsibilities:

From: To: Reason for Leaving:

YES NO
May we contact your previous supervisor for a reference?

Military Service
Branch: From: To:

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.