Highlighted
entries are required. All information is kept strictly
confidential.
First
Name:
Last
Name:
Address:
City:
State:
Zip:
Phone:
E-mail:
Desired Position:
(Multiple Selections Allowed)
List
Other:
Attach resume or other
documents:
EMPLOYMENT
Enter
your employment history, beginning with most recent experience.
Employer 1:
Address/City:
From
(MM/YYYY):
To
(MM/YYYY):
Supervisor:
Phone:
Salary:
Type
of Work:
Reason
for Leaving:
Employer 2:
Address/City:
From
(MM/YYYY):
To
(MM/YYYY):
Supervisor:
Phone:
Salary:
Type
of Work:
Reason
for Leaving:
Employer 3:
Address/City:
From
(MM/YYYY):
To
(MM/YYYY):
Supervisor:
Phone:
Salary:
Type
of Work:
Reason
for Leaving:
EDUCATION
Name & Location of
School
Select Last Year
Completed
Major Course
Diploma/Degree
High
School
College/University
College/University
Business
or Trade School
PERSONAL INFORMATION
Do you have a high-speed Internet
connection?
Yes
No
Do you have a scanner?
Yes
No
Briefly describe any
computer skills you
may have or word processing software you are familiar with.
List any Hermetic or esoteric
organizations to which you have been a member.
If you are experienced
operator of any office machines or equipment, please list:
In what year were you born?
What is your astrological sign?
If you have experience as a
cashier or working at conventions, please list:
Do you have any other skills
you wish to mention?:
Are you presently employed?
Yes
No
When would you be
available?
REFERENCES
(Optional)
List
individuals familiar with your qualifications.
1)
Name of Reference:
2)
Name of Reference:
Occupation:
Occupation:
Address:
Address:
City/State/Zip:
City/State/Zip:
Phone:
Phone:
Relationship:
Relationship:
How
long known:
How
long known:
How Were You Referred To This
Job:
Qualified applicants receive equal consideration. No
question is asked for the purpose of excluding any applicant
due to race, creed, color, national origin, religion, age,
sex, handicap, marital status, sexual
orientation, or any other characteristic protected by law.
We are equal opportunity employer.
I wish to also be considered
for volunteer/intern positions.