Hagemeister Park - Employment

(* = Required Fields)

PERSONAL INFORMATION

Please provide full and accurate details.

First Name*

Last Name*

Address*

Apt or Unit #:

City*

State*

ZIP*

Phone*

Email*:

Position applying for*

Date available to start

Salary Requirements

Type of employment desired *

Are you a citizen of the United States*

If no, do you have work papers?

Do you have a valid driver's license?

How were you referred to Hagemeister Park?

If you are under 18 and we require a work permit, can you furnish one?

If no, please explain:

Special Skills or Qualifications

Please summarize your special skills or qualifications for this position in the space provided below.

Education

Please provide full and accurate details about your education.

High School

Name *

City *

State *

ZIP *

# years completed *

Did you graduate? *

College

Name

City

State

ZIP

# years completed

Did you graduate?

Other School

Name

City

State

ZIP

# years completed

Did you graduate?

Employment History

Please provide details about your previous employment, beginning with the most recent position.

Job 1

Dates of employment

From

Company Name

City

State

ZIP

Position(s) held

Supervisor name

Starting salary and title

Ending salary and title

Responsibilities

Reason for leaving

May we contact this employer for reference?

Job 2

Dates of employment

From

Company Name

City

State

ZIP

Position(s) held

Supervisor name

Starting salary and title

Ending salary and title

Responsibilities

Reason for leaving

May we contact this employer for reference?

Job 3

Dates of employment

From

Company Name

City

State

ZIP

Position(s) held

Supervisor name

Starting salary and title

Ending salary and title

Responsibilities

Reason for leaving

May we contact this employer for reference?

References

Please furnish the names, addresses and telephone numbers of two people to whom you are not related and by whom you have not been employed:

Reference 1

Company Name

City

State

ZIP

Phone

Reference 1

Company Name

City

State

ZIP

Phone

I certify that my answers are true and complete to the best of my knowledge. I authorize Hagemeister Park to make such investigations and inquiries of my personal, employment, educational, financial, or medical history and other related matters as may be necessary for an employment decision.

I hereby release employers, schools or persons from all liability in responding to inquiries in connection with my application.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

Applicant Initials

EMPLOYMENT

PERSONAL INFORMATION

Special Skills or Qualifications

Education

Employment History

References