Job Application Form Sample

Many employers require all applicants for employment, regardless of the job they apply for, to complete a job application form. You may be asked to submit a job application even if you have applied for a position with a resume and cover letter. This way the employer will have consistent data on file for all applicants.

A signed (paper or electronically) application for employment also serves as your verification that the information you have listed on the application is true.

If hired, are you willing to submit to and pass a controlled substance test? [ ] Y or [ ] N

Position and Availability

Position Applied For: ___________________________

Salary desired: $______

Are you applying for:

Temporary work – such as summer or holiday work? [ ] Y or [ ] N
Regular part-time work? [ ] Y or [ ] N
Regular full-time work? [ ] Y or [ ] N

Days/Hours Available

Monday ____
Tuesday ____
Wednesday ____
Thursday ____
Friday ____
Saturday ____
Sunday ____

Hours Available: from _______ to ______

If applying for temporary work, when will you be available

___________________________________________

If hired, on what date can you start working? ___ / ___ / ___

Can you work on the weekends? [ ] Y or [ ] N

Can you work evenings? [ ] Y or [ ] N

Are you available to work overtime? [ ] Y or [ ] N

Are you able to perform the essential functions of the job for which you are applying, either with / without reasonable accommodation?

[ ] Y or [ ] N

If no, describe the functions that cannot be performed
_____________________________________________________________

Education, Training and Experience

High School:
School name: ________________________
School address:________________________
School city, state, zip:________________________________

Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _______________

College / University:
School name: __________________________
School address:________________________
School city, state, zip:________________________________

Number of years completed: ________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: __________________

Vocational School:
Name: ________________________
Address:______________________
City, state, zip:________________________________

Number of years completed: ________
Did you graduate? [ ] Y or [ ] N
Degree / diploma? : __________________

Military:
Branch: ________________________
Rank in Military:________________________
Total Years of Service: ________
Skills/duties: ________
Related details:________________________________

Skills and Qualifications: Licenses, Skills, Training, Awards

_____________________________________________________________

Do you speak, write or understand any foreign languages? [ ] Y or [ ] N

If yes, describe which languages(s) and how fluent of a speaker you consider yourself to be. ____________________

Employment History

You should be prepared to detail each position for the past five years, and account for any gaps in employment during that period.

Are you currently employed? [ ] Y or [ ] N

If you are currently employed, may we contact your current employer? [ ] Y or [ ] N

Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type:[ ________________________
Address:________________________
City, state, zip:________________________________

Length of Employment (Include Dates): _____________________
Position & Duties:_______________________________________________________
Reason for Leaving: _____________________________________________________________

Previous Positions:
Include for each employer/position for the past five years:

Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type: ________________________
Address:________________________
City, state, zip:________________________________

References

List below three persons who have knowledge of your work performance within the last four years. Please include professional references only.

Name – First, Last: ______________________________________
Telephone Number:____________________________
Address:________________________
City, state, zip:________________________________
Occupation: ______________________________________
Number of Years Acquainted: ______________________________________

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.

Signature______________________________

Date__________________________________

Required Information

When you complete an employment application, you will be required to provide your contact information, your work history including companies worked for, positions held, and starting and ending dates of employment, and your educational history.

You may also be asked to provide references. Here’s information on when companies may require references with a job application.

Make a List of the Information You Need to Apply

Before you start applying for a job, make a list of all the information you need to apply. If you have your work history and other information on hand, it will be easier to apply.

Review these tips for how to complete an employment application to get started.

Pre-Employment Testing

In some cases, you may be required to take a pre-employment test as part of the online application process. If a test is part of the application, you will be given with instructions for how to take it.

Legal Issues

It is important to know that when you sign or click online to submit a job application, you are verifying that all the information is accurate. If the information you provide is not correct, your application may not be considered or you could lose your job if you have already been hired.

Double check your application before you turn it in to be sure that it’s correct.

Suggested Reading: Best Tips for Filling Out Job Applications

From :Job Application Form Sample