Haug Implement Co.
Application for Employment
Personal Data
Name:
_____________________________________________________________________
Address:
___________________________________________________________________
Phone: ____________________________ Cell phone: ___________________________
What position/department
are you applying for? ___________________________________
Type of employment
requested: _____ Full time _____ Part
time _____ Summer time
Date available for
employment: _______________ Salary requested: ________________
Employment history
1.
Name of
employer: _____________________________________________________
Address
of employer: ___________________________________________________
Phone
number of employer: ______________________________________________
Supervisor’s
name: _____________________________________________________
Dates
of employment: ___________________________________________________
Position:
______________________________________________________________
Pay
rate: _____________________________________________________________
Duties:
_______________________________________________________________ __________________________________________________________________May
we contact them for reference? Yes_____ No_____
2.
Name of
employer: _____________________________________________________
Address
of employer: ___________________________________________________
Phone
number of employer: ______________________________________________
Supervisor’s
name: _____________________________________________________
Dates
of employment: ___________________________________________________
Position:
______________________________________________________________
Pay
rate: _____________________________________________________________
Duties:
_______________________________________________________________ __________________________________________________________________May
we contact them for reference? Yes_____ No_____
3.
Name of
employer: _____________________________________________________
Address
of employer: ___________________________________________________
Phone
number of employer: ______________________________________________
Supervisor’s
name:______________________________________________________
Dates
of employment: ___________________________________________________
Position:
______________________________________________________________
Pay
rate: _____________________________________________________________
Duties:
_______________________________________________________________ __________________________________________________________________May
we contact them for reference? Yes_____ No_____
General experience
What computer
programs/software do you have experience using?_______________________
_______________________________________________________________________
_______________________________________________________________________
What office equipment do
you have experience using? ________________________________
_______________________________________________________________________
_______________________________________________________________________
List any skills, training
or experience that you have that would benefit you in the position you
are applying for:
_________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Education
Highest grade completed in
high school: __________ Did you
graduate? __________
Number of years in college:
__________ Did
you graduate? __________
What was your major?
___________________________________________________
Other
education:______________________________________________________________
______________________________________________________________________
References
Please list 3 references. Do not include former employers or relatives.
1. Name: ___________________________________ Phone: ____________________
Address:
_______________________________________________________________
2. Name: ___________________________________ Phone: ____________________
Address:
_______________________________________________________________
3. Name: ___________________________________ Phone: _____________________
Address: _______________________________________________________________
Acknowledgement
By signing this
application, I certify that all answers given herein are true and complete to
the best of my knowledge. I authorize
investigation of all statements contained in this application for employment as
may be necessary in arriving at an employment decision. In the event of employment, I understand that
false or misleading information given on my application or interview(s) will be
considered sufficient cause for dismissal.
_________________________________________ ___________________________
Signature of applicant Date
Haug Implement Co. is an equal
opportunity employer