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Employment Application

Applicant Information
Full Name
Date of Application
Address (City, State, Zip Code)
Telephone Number
Email Address

Employment Position
Applying For:
How Did You Hear About This Position?
What Days Are You Available For Work?
What Hours or Shifts Are You Available to Work?
On What Date Can You Start Working If You Are Hired?
Do You Have Reliable Transportation To And From Work?

Personal Information
Have You Ever Applied To Work For Itavie Before?
If You Have Applied, When?
Do You Have Any Friends, Relatives, or Acquaintances Working For Itavie?
If Yes, State The Name and Relationship
Are You 18 Years of Age or Older?
Are You A U.S. Citizen or Approved to Work in the United States?
What Document Can You Provide as a Proof of Citizenship or Legal Status?
Will You Consent To a Mandatory Controlled Substance Test?
If Yes, Please Describe Accommodations Required Below
Have You Ever Been Convicted of a Criminal Offense? (Felony or Misdemeanor)
If Yes, Please State the Nature of the Crime(s), When Convicted, and Disposition of the Case

Requested Information
Do You Have Any Conditions Which Would Require Job Accommodations?

Job Skills/Qualifications
Please List Below the Skills and Qualifications You Possess for the Position for Which You Are Applying For

Education and Training
High School (Name, Address, Year Graduated, Degree Earned)
College/University (Name, Address, Year Graduated, Degree Earned)
Vocational School/Specialized Training

Military
Are You A Member of The Armed Forces?
What Branch of the Military Did You Enlist?
What Was Your Military Rank When Discharged?
How Many Years Did You Serve in the Military?
What Military Skills Do You Possess That Would Be An Asset For This Position?

First Employer
Employer Name:
Job Title:
Supervisor Name:
Employer Address: (City, State, & Zip Code)
Employer Telephone:
Dates Employed:
Reason For Leaving:

Second Employer
Employer Name:
Job Title:
Supervisor Name:
Employer Address: (City, State, & Zip Code)
Employer Telephone:
Dates Employed:
Reason For Leaving:
 

Additional Information: