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1410 Chatfield Road Shelby, North Carolina 28150
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EMPLOYMENT APPLICATION
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Name
*
First
Last
Email
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Street Address
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City
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State
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Postal / Zip Code
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Phone Number
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Position Applying For
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Salary Desired
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Days Available
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
How many hours a week can you work?
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Are you willing to work nights?
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Yes
No
Employment Desired
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Full-Time
Part-Time
Full-Time or Part-Time
High School/College Information
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Please list all educational history, including a list of schools attended (name + address), # of years completed, and any major/degree.
nights? many work?
Have you ever been convicted of a crime?
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Yes
No
If yes, please explain:
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Number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) or rehabilitation.
References
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Please list two references other than relatives or friends. Provide contact information for each.
Work Experience
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Please provide a list of work experience from most recent to least recent for the last 5 years. Please include employer address, name of supervisor, dates of employment, salary, title, and reason for leaving.
May we contact your current employer?
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Yes
No
Additional Information
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Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.
Submit
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