Sample Job Application Form

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment on race, age, color, sex, religion, national origin or other protected classification.

 

Name:	______________________	_________________	___________	Date:___________
	Last	First	Middle
Address:	____________________	___________________	_____________	_______________
	Street	City	State	Zip Code
Telephone:	________________

 

Are you over 18 years old? [ ] Yes [ ] No

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? [ ] Yes [ ] No

How did you learn of this opening? _________________________________________

_____________________________________________________________________

Have you ever worked here before? [ ] Yes [ ] No

Are there any hours, shifts or days you cannot or will not work?

_____________________________________________________________________

Shift preferred: Part-time ____ Full-time____

Are you willing to work overtime as required? [ ] Yes [ ] No

Have you ever been convicted of a felony? [ ] Yes [ ] No
(Conviction will not necessarily disqualify an applicant for employment.) If yes, describe conditions:_____________________________________________________

_____________________________________________________________

 

Authored by: SBDC Counseling Committee, SBDC Finance Committee, SBDC Marketing Committee and The Florida Small Business Development Center
Source: Missouri Small Business Development Centers Professional Development Manual
Date Reviewed: 10/1/01