APPLICATION FOR EMPLOYMENT

APPLICANT INFORMATION
Last Name Street Address City Phone Date Available Position Applied for Are you a citizen of the United States? Have you ever worked for this company? Have you ever been convicted of a felony? YES YES YES NO NO NO If no, are you authorized to work in the U.S.? If so, when? If yes, explain YES NO YES NO Social Security No. State E-mail Address Desired Salary First M.I. Date

Apartment/Unit # ZIP

Are you able to perform the essential functions of the position you are applying with or without a reasonable accommodation?

AVAILABILITY
Day of Week Hours Sunday Monday Tuesday Wednesday Thursday Friday Saturday

EDUCATION
High School From College From Other From To Did you graduate? To Did you graduate? To Did you graduate? Address YES Address YES Address YES NO Degree NO Degree NO Degree

ADDITIONAL SKILLS: Describe skills relevant to the job for which you are applying
SKILL Office equipment, (typing speed, programs, etc.) Technical Skills, Professional Licenses Computer Software Other TYPE OF EXPERIENCE LEVEL OF EXPERTISE

REFERENCES
Please list three professional references, not a former supervisor.

PREVIOUS EMPLOYMENT
Company Address Job Title Responsibilities From To Reason for Leaving YES NO Phone Supervisor Starting Salary $ Ending Salary $ ( ) Starting Salary Phone Supervisor $ Ending Salary $ ( )

May we contact your previous supervisor for a reference? Company Address Job Title Responsibilities From To Reason for Leaving

May we contact your previous supervisor for a reference? Company Address Job Title Responsibilities From To Reason for Leaving

YES

NO Phone Supervisor ( )

Starting Salary

Ending Salary

May we contact your previous supervisor for a reference?

YES

NO

MILITARY SERVICE
Branch Rank at Discharge If other than honorable, explain From To

Type of Discharge

DISCLAIMER AND SIGNATURE

The information provided in this Application for Employment is true, correct and complete. If employed, any misstatements or omissions of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. I understand that SweetFrog Enterprises is an Equal Opportunity Employer. No question on this application form is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state or federal law. Equal access to employment, services and programs is available to all persons. Signature Date

Equal Employment Opportunity Application Supplement

Applicant Information Full Name: Address:

Last Street Address

First

M.I. Apartment/Unit #

Home Phone:

City

Social Security Number:

State

ZIP Code

Position Applied for: Voluntary Information

This information is being requested in accordance with federal regulations. The information is voluntary and will not be used when considering you for employment with our company.
Racial or Ethnic Group American Indian/Alaskan Hispanic/Latino Asian Native Hawaiian/Pacific Islander White/Caucasian Black/African American Two or More Races

Gender Female Military Service Pre-Vietnam Era Post-Vietnam Era How did you hear about this position? Newspaper Job Fair Other Company Employee Placement Office Professional Publication Web Site Vietnam Era Disabled Veteran Male