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Termite Elimination

Employment Application

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or an other legally protected status.


How Did You Learn About Us?
 Advertisement  Relative  Emplyment Agency
 Inquiry  Friend  Other 
Last Name
 First Name
 Middle Name
Address
 Number
 City
 State
 Zip
Telephone Number(s)
  Social Security Number
   
Best time to contact you at home is:   AM  PM
If you are under 18 years of age, can you provide required proof of your eligibility to work?  Yes  No
Have you ever filed and application with us before?  Yes  No
     If Yes, Give Date 
Have you ever been employed with us before?  Yes  No
     If Yes, Give Date 
Do any of your friends or relatives, other than spouse, work here?  Yes  No
Are you currently employeed?  Yes  No
May we contact your present employer?  Yes  No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
    Proof of citizenship or immigration status will be required upon employment  Yes  No
Date available for work
Desired Salary Range?
Availablility:
 Full Time (indicate shift)  1st Shift   2nd Shift   3rd Shift
 Part Time
(indicate time)  Mornings   Afternoons   Evenings
 Temporary (indicate dates available)  Start  End 
Are you currently on "lay-off" status and subject to recall?  Yes  No
Can you travel if a job requries it?  Yes  No
EDUCATION
Grade Completed
Describe any specialized training, apprenticeship, skill and extra-curricular activities:
Describe any job-related training received in the United States Military:
ADDITIONAL INFORMATION
Other Qualifications:
Summarize special job-related skills and qualifications acquired from employment or other experience.
REFERENCES
  Name Address Phone
1
2
3
EMPLOYMENT EXPERIENCE
Employer
 Address
 Phone
Job Title
 Supervisor
 Reason For Leaving
Employed
From
To		          HourlyRate/Salary
Starting
Final
Work Performed
Employer
 Address
 Phone
Job Title
 Supervisor
 Reason For Leaving
Employed
From
To		          HourlyRate/Salary
Starting
Final
Work Performed
Employer
 Address
 Phone
Job Title
 Supervisor
 Reason For Leaving
Employed
From
To		          HourlyRate/Salary
Starting
Final
Work Performed
  

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