Demo of Job Application Form

APPLICATION FOR EMPLOYMENT (DEMONSTRATION)
Thank you for applying for this position! We appreciate your time to fill out this application and the pre-interview questions that follow the application.

(NOTES: For this demonstration, roll your mouse over the fields with an asterisk * to see details about the question. If the details do not appear, you will need to turn off your pop-up blocker.

If you type in a few answers and include your email address, this job application, with your answers, will be converted to a PDF file and emailed to you.)
Hidden Email Sender Name
Hidden Reply Email
The OnlineJobAp code number from the job ad listing *
Position you are seeking
First Name
Last Name
Street Address
Email Address *
City
State
Zip
Best phone number
Alternate phone number
Copyright 2015 OnlineJobAp.com. All rights reserved.

Employment History Information
Please provide us with the details of your last three jobs.

Current or Most Recent Employer
Your current employer, or your most-recent employer
City, State
Position Held
Start Date
Start Date
End Date (If you are still employed, leave blank)
If you are still employed, please let us know what you prefer: *

Please do not contactFeel free to contact
Employer phone
Your supervisor
Your supervisor's supervisor
Describe your duties
Reason for leaving

Next Employer
Employer Name
City, State
Position Held
Start Date
End Date
Employer phone
Your supervisor
Click to edit
Your supervisor's supervisor
Describe your duties
Reason for leaving

Third Employer
Employer Name
City, State
Position Held
Start date
End Date
Employer phone
Your supervisor
Your supervisor's supervisor
Describe your duties
Reason for leaving

Personal References
If you wish, you can include up to three personal references, such as teachers, coaches or religious leaders, who are familiar with your ability to work.

First Reference
First Reference
Phone Number
Relationship
Years Known

Second Reference
Second Reference
Phone Number
Relationship
Years Known

Third Reference
Third Reference
Phone Number
Relationship
Years Known

Education

High School
Name & City/State of High School
Did you graduate?

YesNoAttending

College
Name & City/State of College or University
Course of Study/ Degree Earned
Did you graduate?

YesNoAttending

Other Education
Name & City/State of your other education (specify)
Course of Study/ Degree Earned
Did you graduate?

YesNoAttending

Legal Agreements
1. The information in this application is true. I authorize you to investigate all of the statements in this application. I understand that if I am hired, and any statements in this application are found to be false, I will be dismissed from employment.
2. I understand and agree that if accepted for employment it will be for no definite period of time or pay. Regardless of the date of payment of my wages or salary, I may be terminated at any time without any previous notification, also known as "at-will employment." This means I or my employer may terminate my employment at will. No one other than the owner of this business has the authority to alter this arrangement, to form an agreement for employment for a specified period of time, or to make any agreement contrary to this policy. Any change to this policy must be in writing and signed by the owner of this business.
3. I can and will provide documents proving my legal right to work in the United States prior to beginning employment.
4. I give permission for you or your agent to investigate my background which may include checking my employment history, driving record, credit history, education records, personal character references and any public records, as allowed by law. I authorize, without reservation, any law enforcement agency, state agency, information service company, public or private institution, or past employer to provide you with any information they may have regarding my background, as allowed by law. I authorize you and my former employers to openly discuss the information contained in this application and my past employment history.
5. I agree to being tested for illegal drug use both before and at any time during employment. If I refuse to take a drug-use test, or if the test shows I use illegal drugs, I understand I will be disqualified for the job.
Please select one *

I agree with all five statements above.I disagree with one or more of the statements above.
Please explain
By typing my name below, I acknowledge and agree that I am signing this Job Application as if actually signed in writing.
Signature
Date

Please describe a time when you made an unhappy patient or customer into a happy patient or customer *
Describe a time where you got someone to do something that was for their own good, even though they didn't want to do it at first *
How do you feel about supervising others? *

I love supervising othersI'd like to learn how to supervise othersI can do it, if requiredIt makes me uncomfortableI hate it
What do you do when you disagree with a policy, order or directive? *
How would you feel if your boss asked you to do personal errands for him or her, at full pay? *
If you are hired, how can your new boss help you do your very best work? *
What are your career goals? *
Anything else you would like us to know about you?
Please click "Submit" and your information will be forwarded to your potential employer. You may also print the Job Application for your own records before you click "Submit."

Thank you very much!

(Note: If you entered your email address on the first screen, a copy of this job application will be sent to your email address.)
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APPLICATION FOR EMPLOYMENT (DEMONSTRATION)

Employment History Information

Personal References

Education

Legal Agreements

Pre-interview Questions