Sample Job Application Forms
In many cases, even if you submit a resume, you will also be asked to complete a job application. This way the employer will have consistent data on file for all prospective applicants. Also, your signature on the job application acknowledges that the information is accurate.
Job Application Forms
In many cases, even if you submit a resume, you will also be asked to complete a job
application. This way the employer will have consistent data on file for all prospective
applicants. Also, your signature on the job application acknowledges that the information
is accurate.
Instructions: Print clearly in black or blue ink. Answer all questions. Sign and date the
form.
Application Form
Applicant Information
Applicant Name _____________________
Home Phone _______________________
Other ____________________________
Email Address _____________________
Current Address:
Number and street ____________________
City ________________________________
State & Zip ____________________________
How were you referred to Company?:___________________________
Employment Positions
Position(s) applying for:________________________________
Are you applying for:
• Temporary work – such as summer or holiday work? [ ] Y or [ ] N
• Regular part-time work? [ ] Y or [ ] N
• Regular full-time work? [ ] Y or [ ] N
What days and hours are you available for work?
___________________________________________
If applying for temporary work, when will you be available?
___________________________________________
If hired, on what date can you start working? ___ / ___ / ___
Can you work on the weekends? [ ] Y or [ ] N
Can you work evenings? [ ] Y or [ ] N
Are you available to work overtime? [ ] Y or [ ] N
Salary desired: $________________________________
Personal Information:
Have you ever applied to / worked for Company before? [ ] Y or [ ] N
If yes, please explain (include date): ________________________
Do you have any friends, relatives, or acquaintances working for Company? [ ] Y or [ ] N
If yes, state name & relationship: ________________________________
If hired, would you have transportation to/from work? [ ] Y or [ ] N
Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal
age.) [ ] Y or [ ] N
If hired, would you be able to present evidence of your U.S.
citizenship or proof of your legal right to work in the United States? [ ] Y or [ ] N
If hired, are you willing to submit to and pass a controlled substance test? [ ] Y or [ ] N
Are you able to perform the essential functions of the job for which you are applying,
either with / without reasonable accommodation? [ ] Y or [ ] N
If no, describe the functions that cannot be performed
_____________________________________________________________
(Note: Company complies with the ADA and consider reasonable accommodation
measures that may be necessary for eligible applicants/employees to perform essential
functions. It is possible that a hire may be tested on skill/agility and may be subject to a
medical examination conducted by a medical professional.)
Have you ever been convicted of a criminal offense (felony or misdemeanor)? [ ] Y or [ ]
N
If yes, please describe the crime - state nature of the crime(s), when and where convicted
and disposition of the
case.________________________________________________________________
(Note: No applicant will be denied employment solely on the grounds of conviction of a
criminal offense. The date of the offense, the nature of the offense, including any
significant details that affect the description of the event, and the surrounding
circumstances and the relevance of the offense to the position(s) applied for may,
however, be considered.)
Education, Training and Experience
High School:
School name: ________________________
School address:________________________
School city, state, zip:________________________________
Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _______________
College / University:
School name: __________________________
School address:________________________
School city, state, zip:________________________________
Number of years completed: ________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: __________________
Vocational School:
Name: ________________________
Address:______________________
City, state, zip:________________________________
Number of years completed: ________
Did you graduate? [ ] Y or [ ] N
Degree / diploma? : __________________
Military:
Branch: ________________________
Rank in Military:________________________
Total Years of Service: ________
Skills/duties: ________
Related details:________________________________
Additional Information
Do you speak, write or understand any foreign languages? [ ] Y or [ ] N
If yes, describe which languages(s) and how fluent of a speaker you consider yourself to
be. ____________________
Do you have any other experience, training, qualifications, or skills which you feel
should be brought to our attention, in the case that they make you especially suited for
working with us?
[ ] Y or [ ] N
If yes, please explain ___________________________________________
Employment History
Are you currently employed? [ ] Y or [ ] N
If you are currently employed, may we contact your current employer? [ ] Y or [ ] N
Below, please describe past and present employment positions, dating back five years.
Please account for all periods of unemployment. Even if you have attached a resume,
this section must be completed.
Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type:[ ________________________
Address:________________________
City, state, zip:________________________________
Length of Employment (Include Dates): _____________________
Position & Duties:_______________________________________________________
Reason for Leaving:
_____________________________________________________________
May we contact this employer for references? [ ] Y or [ ] N
Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type: ________________________
Address:________________________
City, state, zip:________________________________
Length of Employment (Include Dates): _____________________
Position & Duties:_______________________________________________________
Reason for Leaving:
_____________________________________________________________
May we contact this employer for references? [ ] Y or [ ] N
Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type: ________________________
Address:________________________
City, state, zip:________________________________
Length of Employment (Include Dates): _____________________
Position & Duties:_______________________________________________________
Reason for Leaving:
_____________________________________________________________
May we contact this employer for references? [ ] Y or [ ] N
References
List below three persons who have knowledge of your work performance within the last
four years.
Please include professional references only.
Name - First, Last: ______________________________________
Telephone Number:____________________________
Address:________________________
City, state, zip:________________________________
Occupation: ______________________________________
Number of Years Acquainted: ______________________________________
Name - First, Last: ______________________________________
Telephone Number:____________________________
Address:________________________
City, state, zip:________________________________
Occupation: ______________________________________
Number of Years Acquainted: ______________________________________
Name - First, Last: ______________________________________
Telephone Number:____________________________
Address:________________________
City, state, zip:________________________________
Occupation: ______________________________________
Number of Years Acquainted: ______________________________________
Please Read and Initial Each Paragraph, then Sign Below
I certify that I have not purposely withheld any information that might adversely affect
my chances for hiring. I attest to the fact that the answers given by me are true & correct
to the best of my knowledge and ability. I understand that any omission (including any
misstatement) of material fact on this application or on any document used to secure can
be grounds for rejection of application or, if I am employed by this company, terms for
my immediate expulsion from the company.
_____
I understand that if I am employed, my employment is not definite and can be terminated
at any time either with or without prior notice, and by either me or the company.
_____
I permit the company to examine my references, record of employment, education record,
and any other information I have provided. I authorize the references I have listed to
disclose any information related to my work record and my professional experiences with
them, without giving me prior notice of such disclosure. In addition, I release the
company, my former employers & all other persons, corporations, partnerships &
associations from any & all claims, demands or liabilities arising out of or in any way
related to such examination or revelation.
_____
Applicant's Signature:______________________________
Date:_________________________________
Job Application Form
PERSONAL INFORMATION:
First Name _____________________________
Middle Name ___________________________
Last Name _____________________________
Street Address
_______________________________________________________
City, province, Zip Code
_______________________________________________________
Phone Number
(___)___________________________________
If you are under age 18, do you have an employment/age certificates?
Yes ___ No ___
Have you been convicted of or pleaded no contest to a felony within the last five years?
Yes_______ No_______
If yes, please explain: _________________________________________
__________________________________________________________
POSITION/AVAILABILITY:
Position Applied For
________________________________________
Days/Hours Available
Monday ____
Tuesday ____
Wednesday ____
Thursday ____
Friday ____
Saturday ____
Sunday ____
Hours Available: from _______ to ______
What date are you available to start work?
________________________________________
EDUCATION:
Name and Address Of School - Degree/Diploma - Graduation Date
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Skills and Qualifications: Licenses, Skills, Training, Awards
_____________________________________________________________
_____________________________________________________________
EMPLOYMENT HISTORY:
Present Or Last Position:
Employer: _____________________________________________________
Address:______________________________________________________
Supervisor: ____________________________________________________
Phone: _______________________________
Email: ________________________________
Position Title: _________________________
From: ______________ To: ______________
Responsibilities: ____________________________________________________
__________________________________________________________
Salary: _______________
Reason for Leaving: ____________________________________________
===========
Previous Position:
Employer: _____________________________________________________
Address:______________________________________________________
Supervisor: ____________________________________________________
Phone: _______________________________
Email: ________________________________
Position Title: _________________________
From: ______________ To: ______________
Responsibilities: ___________________________________________________
__________________________________________________________
Salary: _______________
Reason for Leaving: ____________________________________________
May We Contact Your Present Employer?
Yes _____ No _____
References:
Name/Title Address Phone
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
I certify that information contained in this application is true and complete.
I understand that false information may be grounds for not hiring me or for immediate
termination of employment at any point in the future if I am hired. I authorize the
verification of any or all information listed above.
Signature______________________________
Date__________________________________
Sample Part-Time Job Application
Company Name
Part-Time Employment Application
Applicant Information
Applicant Name ___________________
Home Phone _____________________
Cell Phone _______________________
Email Address ____________________
Current Address:
Number and street _______________________
City _________________________________
State & Zip _____________________________
How were you referred to Company?:________________________
Positions
Position(s) applying for:________________________________
Are you applying for:
• Temporary part-time work – such as summer or holiday work? [ ] Y or [ ] N
• Regular part-time work? [ ] Y or [ ] N
What days and hours are you available for work?
___________________________________________
If applying for temporary work, when will you be available?
___________________________________________
If hired, on what date can you start working? ___ / ___ / ___
Can you work on the weekends? [ ] Y or [ ] N
Can you work evenings? [ ] Y or [ ] N
Personal Information:
Have you ever applied to / worked for Company before? [ ] Y or [ ] N
If yes, please explain (include date): ________________________
If hired, would you have transportation to/from work? [ ] Y or [ ] N
Are you over the age of 18? If under 18, do you have working papers? [ ] Y or [ ] N
If hired, would you be able to present evidence of your U.S.
citizenship or proof of your legal right to work in the United States? [ ] Y or [ ] N
If hired, are you willing to submit to and pass a controlled substance test? [ ] Y or [ ] N
Have you ever been convicted of a criminal offense (felony or misdemeanor)? [ ] Y or [ ]
N
If yes, please state the nature of the crime(s), when and where convicted and disposition
of the case.____________________________________________
(Note: No applicant will be denied employment solely on the grounds of conviction of a
criminal offense.
Education, Training and Experience
High School:
School name: ________________________
School address:________________________
School city, state, zip:________________________________
Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _______________
College / University:
School name: __________________________
School address:________________________
School city, state, zip:________________________________
Number of years completed: ________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: __________________
Vocational School:
Name: ________________________
Address:______________________
City, state, zip:________________________________
Number of years completed: ________
Did you graduate? [ ] Y or [ ] N
Degree / diploma? : __________________
Do you have any other experience, training, qualifications, or skills which you feel
should be brought to our attention, in the case that they make you especially suited for
working with us?
[ ] Y or [ ] N
If yes, please explain ___________________________________________
Employment History
Are you currently employed? [ ] Y or [ ] N
If you are currently employed, may we contact your current employer? [ ] Y or [ ] N
Below, please describe past and present employment positions, dating back five years.
Please account for all periods of unemployment. Even if you have attached a resume,
this section must be completed.
Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type:[ ________________________
Address:________________________
City, province, zip:________________________________
Length of Employment (Include Dates): _____________________
Position & Duties:_______________________________________________________
Reason for Leaving:
_____________________________________________________________
May we contact this employer for references? [ ] Y or [ ] N
Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type: ________________________
Address:________________________
City, province, zip:________________________________
Length of Employment (Include Dates): _____________________
Position & Duties:_______________________________________________________
Reason for Leaving:
_____________________________________________________________
May we contact this employer for references? [ ] Y or [ ] N
Name of Employer:______________________________________
Name of Supervisor:____________________________________
Telephone Number:______________________________________
Business Type: ________________________
Address:________________________
City, province, zip:________________________________
Length of Employment (Include Dates): _____________________
Position & Duties:_______________________________________________________
Reason for Leaving:
_____________________________________________________________
May we contact this employer for references? [ ] Y or [ ] N
References
List below three persons who have knowledge of your work performance within the last
four years.
Please include professional references only.
Name - First, Last: ______________________________________
Telephone Number:____________________________
Address:________________________
City, state, zip:________________________________
Occupation: ______________________________________
Number of Years Acquainted: ______________________________________
Name - First, Last: ______________________________________
Telephone Number:____________________________
Address:________________________
City, state, zip:________________________________
Occupation: ______________________________________
Number of Years Acquainted: ______________________________________
Name - First, Last: ______________________________________
Telephone Number:____________________________
Address:________________________
City, state, zip:________________________________
Occupation: ______________________________________
Number of Years Acquainted: ______________________________________
Please Read and Initial Each Paragraph, then Sign Below
I certify that I have not purposely withheld any information that might adversely affect
my chances for hiring. I attest to the fact that the answers given by me are true & correct
to the best of my knowledge and ability. I understand that any omission (including any
misstatement) of material fact on this application or on any document used to secure can
be grounds for rejection of application or, if I am employed by this company, terms for
my immediate expulsion from the company.
_____
I understand that if I am employed, my employment is not definite and can be terminated
at any time either with or without prior notice, and by either me or the company.
_____
I permit the company to examine my references, record of employment, education record,
and any other information I have provided. I authorize the references I have listed to
disclose any information related to my work record and my professional experiences with
them, without giving me prior notice of such disclosure. In addition, I release the
company, my former employers & all other persons, corporations, partnerships &
associations from any & all claims, demands or liabilities arising out of or in any way
related to such examination or revelation.
_____
Applicant's Signature:______________________________
Date:_________________________________
Retail Job Application Form Sample
Company Name
Retail Employment Application
Applicant Information
Applicant Name
Phone
Address:
Street
City
State & Zip
Age (if under 21):
How were you referred to Company?
Availability
Please be honest with your answers, so we set a schedule that you work for both you and
us.
What days and hours Monday - Sunday) are you available for work?
How many hours per week can you work?
Please Answer the Following Questions:
Why are you applying to work here?
What has been your greatest accomplishment?
If hired, how long do you expect to work here?
Why do customers shop at this store?
What is customer service?
A customer complains that the coffee tastes terrible, what would you do?
What would you do if your replacement doesn't show up when it's time to go home?
A customer leaves without paying for gas, what would you do?
A co-worker is rude to customers, what would you do? Math Questions
The customer's purchase totals $13.93.
They give you a ten dollar bill and a five dollar bill. How much change do you give
them?
If one bottle of soda costs .99, how much does three cost? How much will they cost with
5% tax added on?
Each pot of coffee hold 6 cups. We usually sell 10 cups of coffee every fifteen minutes.
How many pots of coffee will you need to make?
Personal Information:
If hired, would you have transportation to/from work? [ ] Y or [ ] N
Education, Training and Experience
High School / VOC-TECH:
School name: ________________________
School address:________________________
School city, state, zip:________________________________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: _______________
College / University:
School name: __________________________
School address:________________________
School city, state, zip:________________________________
Did you graduate? [ ] Y or [ ] N
Degree / diploma earned: __________________
Why are you applying to work here?
What has been your greatest accomplishment?
If hired, how long do you expect to work here?
Why do customers shop at this store?
What is customer service?
A customer complains that the coffee taste terrible, what would you do?
What would you do if your replacement doesn't show up when it's time to go home?
A customer leaves without paying for gas, what would you do?
A co-worker is nasty to customers, what would you do? [
Math Questions
The customer's purchase totals $13.93. They give you a ten dollar bill and a five dollar
bill. How much change do you give them?
If one bottle of soda costs .99, how much does three cost? How much will they cost with
5% tax addded on?
Each pot of coffee hold 6 cups. We usually sell 10 cups of coffee every fifteen minutes.
How many pots of coffee will you need to make?
Job Applications Via Email
When applying for jobs via email, write your cover letter in the body of an email
message.
If you need help writing a cover letter, use our to get some ideas.
Proofread your email for grammar and spelling (do not trust spell check software).
Remember, this is your chance to make a critical first impression; even an emailed note
needs to be professional and error-free.
Be brief and to the point. Your cover letter should not be any longer than two or three
short paragraphs.
Make sure you include a signature with your full name, email address and phone number.
Include the title of the position you are applying for in the subject line of your message.
Be sure that your email address/screen name has a professional tone.
If the job posting asks you to send an attachment, send your resume as an MSWord
document.
Many employers do not accept attachments. In these cases, paste your resume into your
email message. Use a simple font and remove the fancy formatting. Send the message to
yourself first to test that the formatting works. If everything looks good, resend to the
employer.
