Have you ever been employed by this company before?
If hired, do you have a reliable means of transportation to get to work?
Explain
Have you ever been convicted of a felony or misdemeanor other than a traffic violation?
If yes explain:
Personal Information
Employment Desired
Postition applying for:
Full or Part Time:
Date Available:
Rate of pay desired:
Please indicate below the days and hours on those days that you would be available to work:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Employment History
Please list last 4 jobs held (most recent first)
Name & Place of Employment
Dates of Employment
Job title & Duties
Salary/Wage
Reason for Leaving
Name & Place of Employment
Dates of Employment
Job title & Duties
Salary/Wage
Reason for Leaving
Name & Place of Employment
Dates of Employment
Job title & Duties
Salary/Wage
Reason for Leaving
Name & Place of Employment
Dates of Employment
Job title & Duties
Salary/Wage
Reason for Leaving
May we contact the past and/or present employers listed above?
If no, indicate those you do not want us to contact.
Military Service Veteran?
Education
Schooling
Name of School
Level Completed
GPA
Graduate
High School
College
Trade/Business
Other
References
Name
Phone Number
Years Aquainted
Relationship
In Case of Emergency, Notify:
Name
Phone number/s
Address
By entering the submit button you acknowledge that you have read and agree to the following terms: 1. I authorize investigation of all statements contained on this application except where I have requested on this form that no investigation to be made.
2. Understand that misrepresentation or omission of facts called for is cause for dismissal and that my employment is substantially dependent on truthful answers to the foregoing inquiries.
3. I understand that nothing contained in this employment application or in the granting of an interview is intended to nor does it create an employment contract between Mussy Incorporated and myself for either employment or the providing of any benefit. In the event that an employment relationship is established. I understand that I have the right to terminate my employment at any time for any reason or no reason, and Mussy incorporated retains the same right regarding the discontinuation of my employment.
