Employment

PERSONAL INFORMATION

Name (Last Name First) Present Address

Apt. No. City State Zip

Permanent Address Apt. No. City State

Zip Phone # Email

Are You 18 Years or Older?

Sex

DESIRED EMPLOYMENT

Position Date You Can Start? Salary Desired

Are You Employed Now?

If so, may we inquire of your present employer?

Ever applied to this company before?

Where? When? Reason for Leaving

Name of Last Supervisor

Who referred you to this company?

EDUCATION

School Level: Grammar School

Number of years attend

Did you Graduate?

Subjects Studied

School Level: High School

Number of years attend

Did you Graduate?

Subjects Studied

School Level: College

Number of years attend

Did you Graduate?

Subjects Studied

School Level: Trade, Business or Correspondence School

Number of years attended

Did you Graduate?

Subjects Studied

PREVIOUS EMPLOYMENT

Name of Present or Last Employer

Address

City State Zip

Leaving Date Job Title

May We Contact Your Supervisor?

Name of Supervisor

Phone Number Description of Work

Reason for Leaving

I verify, that all statements made in this application are accurate to the best of my knowledge, and I understand that falsifying information could lead to disqualification of any employment with Arizona Commercial Lighting & Supply, Arizona Commercial Lighting & Supply also reserves the right to disqualify any applicants, who with any intent attempts to defraud Arizona Commercial Lighting & Supply, or commits a crime subject to civil and or criminal penalty.