EmailMe Form - Employment Application

EmailMeForm

TODAY'S DATE: *
MM / DD / YYYY
Position *
Boutique Sales - Lake City, MN
Boutique Sales - La Crosse, WI
Marketing Intern
When can you start? *
MM / DD / YYYY
Upload Your Resume
Word or PDF Documents Only
Contact Information
Name *
First Last
Email *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Home Phone *
### - ### - ####
Mobile Phone *
### - ### - ####
Have you ever been convicted of a felony? *
Have you ever been terminated from a job? *
Do you object to a background or reference check? *
If answering YES to any of the above, please explain:
EMPLOYMENT HISTORY
Most Recent Employer *
Employer Phone *
### - ### - ####
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Dates Employed *
If still employed, enter start date - current
Position *
Hourly Rate of Pay *
$ Dollars . Cents
Please describe your job duties and responsibilities. *
Reason for leaving? *
EMPLOYMENT HISTORY CONTINUED
Previous Employer *
Employer Phone *
### - ### - ####
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Dates Employed *
If still employed, enter start date - current
Position *
Hourly Rate of Pay *
$ Dollars . Cents
Please describe your job duties and responsibilities. *
Reason for leaving? *
EDUCATION
A description of the section goes here.
What is the highest level of education you've completed? *
GED
High School Diploma
Some College
Associates Degree
Bachelors Degree
Masters Degree
Special Studies or Programs? *
Please list your area of expertise and any special skills you posses. *
What are your hobbies and interests? *
Are you comfortable with computers and learning new technology? *
YES
NO
SOMEWHAT
How many hours a week are you looking for? *
Please include minimum and maximum.
Do you have obligations or employment requirements that would restrict you from working flexible hours? *
What days are you able to work? *

ANYTIME MORNING SHIFT AFTERNOON SHIFT

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

SUNDAY
Will you require any leaves of absence in the next 6 months? *
REFERENCES
Please provide at least 2 professional references.
Reference #1: Name *
First Last
Phone *
### - ### - ####
Relationship *
Best time of day to contact? *
HH : MM AM/PM
Reference #2: Name *
First Last
Phone *
### - ### - ####
Relationship *
Best time of day to contact? *
HH : MM AM/PM
Reference #3: Name
First Last
Phone
### - ### - ####
Relationship
Best time of day to contact?
HH : MM AM/PM
Anything else you'd like us to know about you?

	ANYTIME	MORNING SHIFT	AFTERNOON SHIFT
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY

Contact Information

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY CONTINUED

EDUCATION

REFERENCES