Employment Application Form

Position:*

Full time or Part time:

At Which Location*

First Name:*

Last Name:*

Address 1:*

Address 2:

City:*

State:*

Zip Code:*

Day Phone Number:*

Night Phone Number:

Email Address:*

California Resident?*

YesNo

If Yes, since what year?

Work Status:*

If other, please Specify:

Can you provide legal employment evidence:*

YesNo

High School:

Highest Grade:

GPA:

City:

State:

College / University:

Highest Grade:

Major:

City:

State:

Others:

From (mm/dd/yyyy):

To (mm/dd/yyyy):

Degree:

Major:

City:

State:

Company:

Position:

City:

State:

From (mm/dd/yyyy):

To (mm/dd/yyyy):

Company Phone #:

Supervisor:

May we call?

YesNo

If "No", Please explain:

Reason(s) for Leaving:

Company:

Position:

City:

State:

From (mm/dd/yyyy):

To (mm/dd/yyyy):

Company Phone #:

Supervisor:

May we call?

YesNo

If "No", Please explain:

Reason(s) for Leaving:

Company:

Position:

City:

State:

From (mm/dd/yyyy):

To (mm/dd/yyyy):

Company Phone #:

Supervisor:

May we call?

YesNo

If "No", Please explain:

Reason(s) for Leaving:

Training / Skill:

Name:

Relationship:

Contact Phone #:

Name:

Relationship:

Contact Phone #:

Name:

Relationship:

Contact Phone #:

How did you learn about Central Computers?*

If "Others", please specify:

Any relatives working in Central Computer?

If yes, name:

If yes, relationship:

Which days & hours are you available to work?

Available Hours

Total Available Hours (hours/week):

Date Available to Start? (mm/dd/yyyy)

Are you willing to be assigned to another store location?

YesNo

Seasonal? Explain:

Emergency Contact Name:

Relationship:

Tel :

I certify that the information contained in this application is true and correct to the best of my knowledge and I understand that if hired, any misrepresentation, falsification, or material omission of information on this application shall be grounds for dismissal from employment.

I agree, if I am accepted as an employee, to obey all rules and company regulations and policies of Central Computers, Inc.

I understand and agree that if hired, my employment will start on a probation period of 3 months, in which regardless of any reason, may be terminated at any time without prior notice.

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Position

Personal Data

Education

Experiences

Special Skills

References

Additional Information

Acknowledgement: