EmailMe Form - Carolina Cool Application for Employment

EmailMeForm

Name *
First Middle Last
Date *
MM / DD / YYYY
Present Address *

Street Address City State / Province / Region Postal / Zip Code
Permanent Address *

Street Address City State / Province / Region Postal / Zip Code
Phone Number *
### - ### - ####
The best time to contact you: *
Email *
Are you 18 or older? *
Yes
No
If under 18, can you provide proof of your eligibility to work?
Yes
No
Are you prevented from lawfully becoming employed in this country because of visa or immigration status? *
Yes
No
How did you hear about us? *
Advertisement
Employment Agency
Friend
Relative
Inquiry
Other
EMPLOYMENT DESIRED
Position Desired *
Date You Can Start *
Salary Desired *
Are you available to work: *
Full Time
Part Time
Temporarily
Shift Preference *
First Shift
Second Shift
Third Shift
If temporary, what dates are you available?
Are you currently on "lay-off" status and subject to recall? *
Yes
No
Can you travel if the job requires it? *
Yes
No
Are You Employed Now? *
If so, may we inquire of your present employer? *
Have you applied with us before? *
Yes
No
Where? *
When? *
Referred by: *
Have you been employed with us before? *
Yes
No
If yes, when?
Are any of your friends or relatives presently employed with us? *
Yes
No
If yes, who?
EDUCATION
*

Name & Location of School No of Years Attended Did You Graduate? Subjects Studied

High School

College

Trade School
Describe Any Special Skills or Training
Activities
US Military Service *
Rank *
Please describe any job-related training received in the US Military:
EMPLOYMENT
List below the last three employers, most recent one first.
Last Employer *

Employer Name

Address

Phone

Position Held

Dates (From - To)

Salary

Reason for Leaving
Second Last Employer *

Employer Name

Address

Phone

Position Held

Dates (From - To)

Salary

Reason for Leaving
Third Last Employer *

Employer Name

Address

Phone

Position Held

Dates (From - To)

Salary

Reason for Leaving
REFERENCES
Reference 1: *

Name

Address

Phone
Reference 2: *

Name

Address

Phone
Reference 3: *

Name

Address

Phone
I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY
ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND
I UNDERSTAND THAT IF ANY FALSE INFORMATION,
OMISSIONS, OR MISREPRESENTATIONS ARE
DISCOVERED, MY APPLICATION MAY BE REJECTED, AND,
IF I AM EMPLOYED. MY EMPLOYMENT MAY BE
TERMINATED AT ANY TIME.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS ON THIS APPLICATION AS MAY BE NECESSARY IN ARRIVING AT AN EMPLOYMENT DECISION.

I HEREBY UNDERSTAND AND ACKNOWLEDGE THAT, UNLESS OTHERWISE DEFINED BY APPLICABLE LAW, ANY EMPLOYMENT RELATIONSHIP WITH THIS ORGANIZATION IS OF AN "AT WILL" NATURE, WHICH MEANS THAT THE EMPLOYEE MAY RESIGN AT ANY TIME AND THE EMPLOYER MAY DISCHARGE THE EMPLOYEE AT ANY TIME, WITH OR WITHOUT CAUSE. IT IS FURTHER UNDERSTOOD THAT THIS "AT WILL" EMPLOYMENT RELATIONSHIP MAY NOT BE CHANGED BY ANY WRITTEN DOCUMENT OR BY CONDUCT UNLESS SUCH CHANGE IS SPECIFICALLY ACKNOWLEDGED IN WRITING BY AN EXECUTIVE OF THIS ORGANIZATION.
Signature of Applicant *
Clear
Date *
MM / DD / YYYY

	Name & Location of School	No of Years Attended	Did You Graduate?	Subjects Studied
High School
College
Trade School

Employer Name
Address
Phone
Position Held
Dates (From - To)
Salary
Reason for Leaving

EMPLOYMENT DESIRED

EDUCATION

EMPLOYMENT

REFERENCES