Application for Employment


We appreciate your interest in Connection Technology Center. Connection Technology Center offers equal opportunities to all persons without regard to race, color religion, age, sex, disability, national origin, ancestry, citizenship, military or veteran status, marital status, sexual orientation, domestic violence victim status, predisposing genetic characteristics or genetic information, or any other status protected by law.

Personal Information


Name:

Telephone:

Email Address:

Current Address:


If under 18 years of age, do you have a work permit ?
Yes No
Are you legally eligible for employment in the United States?
Yes No
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required I9 employment eligibility verification document form upon hire.

Employment Desired


Position (s) applied for:

Start Date:


Have you ever worked for this company before?
Yes No
When:

Supervisor:

Reason for Leaving

Education


Highest Grade Completed:

Name of last school attended:

License, Vocational or Trade Training:

Professional References


Please give the name of three persons not related to you, whom you have known professionally at least three years
Name

Address

Telephone:

Years Known

Name

Address

Telephone:

Years Known

Name

Address

Telephone:

Years Known

Employment History

List all your work expierence (starting with your most recent). Please account for all periods of unemployment in this section.
Dates Employed:
From: To: Salary:
Employer Information:
Name of Employer: Address: Job Title: Name of Supervisor:
Briefly describe your job duties and work expierence: Reason for leaving: (delete this job)


May we contact your present employer at this time?
Yes No
 

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