Lafayette - Employment Application Form

Employment Application Form:
To apply, please complete this form in full and transmit electronically. The omission of any information could prohibit further consideration of your application. This application is valid for 60 days from the date of signature.
Personal Information:
Full Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State

Zip Code
Phone Number

Area Code Phone Number
E-mail
Are you legally eligible to work in the United States

Yes No
Have you ever been convicted of a felony (which has not been restricted or expunged from your record)?

Yes No
If Yes, please explain
Employment Desired:
Position Applying For
Date You Can Start

Month Day Year
Salary Desired
Have You Worked at BeeHive Homes Before?

Yes No
Have You Applied with BeeHive Homes Before?

Yes No
Full Time or Part Time Employment?

Full Time Part Time
Preferred Shift
Education:
High School
Name of High School Attended
Graduated?

Yes
College
Name of College/University Attended
Graduated?

Yes
Area of Study/Degree
Additional College (if applicable)
Name of College/University Attended
Graduated?

Yes
Area of Study/Degree
Additional Schooling or Training
Skills/Certifications:

Please list all certifications, licenses, training courses
Skills
List any relevant skills
Current Employment:
Current Employer
Name of Current Employer or NONE if not Employed
Position
Salary
Reason for Leaving?
Start Date

Month Day Year
May We Contact?

Yes No
Previous Employment:
Previous Employer
Name of Previous Employer
Position
Wage / Salary
Reason for Leaving?
Start Date

Month Day Year
End Date

Month Day Year
Previous Employer
Name of Previous Employer
Position
Wage / Salary
Reason for Leaving?
Start Date

Month Day Year
End Date

Month Day Year
References:
Reference 1
Name of Reference
Relationship
Phone
Email
Reference 2
Name of Reference
Relationship
Phone
Email
Reference 3
Name of Reference
Relationship
Phone
Email
Cover Letter & Resume (Optional):
Cover Letter
Resume
Send Application:
BeeHive Homes of Lafayette is an equal opportunity employer. We do not discriminate against otherwise qualified applicants on the basis of age, ancestry, color, creed, disability/handicap, gender identity, marital status, national origin, race, religion or veteran status.
Should be Empty:

Employment Application Form:

Personal Information:

Employment Desired:

Education:

Skills/Certifications:

Current Employment:

Previous Employment:

References:

Cover Letter & Resume (Optional):

Send Application: