Benicia High School Virtual Business

Employment Application

APPLICANT INFORMATION.

Last Name First M.I.  Date 
Address  Apt/unit # 
City  State  ZIP 
Phone  E-mail Address: 
Date Available:  Stu. ID  Salary Req 
Position Applied for 
Are you a U.S. citizen?Yes No If no, are you authorized to work in the U.S.?Yes No
Have you ever worked for this company?Yes No If so, when?
Convicted of a felony? Yes No  If yes, Explain  
EDUCATION
High School Address
From   To   Graduate? Yes  No Degree 
College   Address  
From   To   Graduate? Yes  No Degree 
Other   Address  
From   To   Graduate? Yes  No Degree 
REFERENCES
Please list three professional references
Full Name   Relationship  
Company   Phone  
Address 
Full Name   Relationship  
Company   Phone  
Address 
Full Name   Relationship  
Company   Phone  
Address 
PREVIOUS EMPLOYMENT
Company   Phone  
Address  Supervisor 
Job Title  Start Salary   End Salary 
Responsibilities 
From  To  Reason for Leaving 
May we contact your previous supervisor for a reference? Yes   No 
Company   Phone  
Address  Supervisor 
Job Title  Start Salary   End Salary 
Responsibilities 
From  To  Reason for Leaving 
May we contact your previous supervisor for a reference? Yes   No 
Company   Phone  
Address  Supervisor 
Job Title  Start Salary   End Salary 
Responsibilities 
From  To  Reason for Leaving 
May we contact your previous supervisor for a reference? Yes   No 
MILITARY SERVICE
Branch   From  
To     
Rank at Discharge  Type 
If other than honorable, explain 
I certify that my answers are true and complete to the best of my knowledge.  Yes No
If this application leads to employment, I understand that false or
misleading information may result in my release.
 Yes No