Personal Information
Name (Last, First, Middle): required
Present Address: required
City: required
How did you learn of our company or this position opening? required
If related to anyone who works for A.J. Johns Inc., State Name, Department & Location:
Emergency Contact
Name: required
Address: required
City: required
Phone: required
Employment Desired
May we inquire of your present employer? required
Ever applied or worked at A.J. Johns, Inc. before? required
Are there any days, shifts or hours you will not work? required
If yes, please explain:
Education
Grammer School:
Name and Location of School:
Degree / Certificate:
Subjects Studied:
Grade Average:
High School:
Name and Location of School:
Degree / Certificate:
Subjects Studied:
Grade Average:
College:
Name and Location of School:
Degree / Certificate:
Subjects Studied:
Grade Average:
Trade, Business or Correspondence School:
Name and Location of School:
Degree / Certificate:
Subjects Studied:
Grade Average:
Other (including graduate school):
Name and Location of School:
Degree / Certificate:
Subjects Studied:
Grade Average:
Have you ever been convicted of, or pled guilty, no contest or nolo contendere to a crime? required
If yes, give details (date, place, offense(s), disposition, etc.):
Have you ever been charged with a crime and either been placed on a court-ordered probation, had adjudication withheld, entered a pre-trial intervention program or have any criminal charges now pending? required
If yes, give details (date, place, offense(s), disposition, etc.):
Previous Employment
List below sequentially all of your employers in the last ten (10) years beginning with your current or most recent employer.
Employer 1
Employer Name:
Address:
Position and Job Duties
Salary
Reason for Leaving
Employer 2
Employer Name:
Address:
Position and Job Duties
Salary
Reason for Leaving
Employer 3
Employer Name:
Address:
Position and Job Duties
Salary
Reason for Leaving
Employer 4
Employer Name:
Address:
Position and Job Duties
Salary
Reason for Leaving
May we contact the employer(s) listed above? required
Did you work for any of these employers under a different name: required
If yes, which employer(s) and under what name(s)?
Please explain any gaps in your employment history:
Have you received any written reprimands or disciplinary suspension during any previous employment? required
If yes, please explain:
Have you ever been discharged or asked to resign? required
If yes, please explain (include by whom, when and for what):
References
Give below the names of three persons not related to you, whom you have known at least one year.
Reference 1
Name:
Address:
Business:
Years Acquainted:
Reference 2
Name:
Address:
Business:
Years Acquainted:
Reference 3
Name:
Address:
Business:
Years Acquainted:
Skills
Please list below any specific skills, education, training, or certifications that apply to our industry that you have received and the approximate dates of each.