Application Employment Questions Name* First Last Phone*Email* Address* City* State* Zip* Referred By Date of Birth* DD slash MM slash YYYY What position are you applying for?* What is your weekly availability to work Hours per week?* Date You Can Start* MM slash DD slash YYYY Are You Currently Employed?* Yes No EducationHigh School* City* State* Did You Graduate?* Yes No College City State Did You Graduate?* Yes No Degree Major How many jobs have you held within the last two years?* Have you ever been terminated from a job?* Yes No If so, Please Explain Are you able to lift 50 lbs?* Yes No Are you able to comply with spending 6-9 hours on your feet at a time?* Yes No Please explain any specialized training or courses you have received that relate to the position Work apparel, no excessive jewelry or makeup, and good hygiene are requirements of the position. Are you willing to comply?* Yes No Do you have reliable form of transportation?* Yes No Former Employers*