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