APPLICATION FOR EMPLOYMENT

TE-CO considers all applicants for any and all positions and will not discriminate based on the following protected classes: race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, ancestry, or any other legally protected status.

Position(s) applied for:*

Date of application:*

/ /

Last name*

First name*

Middle name*

Address*

Number

City*

State*

Zip Code*

Telephone number(s)*

Format: 123-456-7890

Email Address*

If you are less than 18 years of age, you will be required to provide proof of your eligibility to work.

Would you like to be added to the TE-CO email list?
(this email list will only notify you of future job openings)

Yes

Have you ever been employed with us before?

Yes

Are you currently employed?

Yes

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

Are you available to work:

Full Time

Part Time

Shift Work

Temporary

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

Education

High School

Name & Address of School

Phone Number

Course of Study

Years Completed

Diploma Degree

Undergraduate College

Name & Address of School

Phone Number

Course of Study

Years Completed

Diploma Degree

Graduate Professional

Name & Address of School

Phone Number

Course of Study

Years Completed

Diploma Degree

Other(Specify)

Name & Address of School

Phone Number

Course of Study

Years Completed

Diploma Degree

	Name & Address of School	Phone Number	Course of Study	Years Completed	Diploma Degree
High School
Undergraduate College
Graduate Professional
Other(Specify)

Describe any specialized training, apprenticeship, skills and extra-curricular activities.

Describe any job-related training received in the United States military.

References

Name:

Address:

Area Code:

Phone#:

Name:

Address:

Area Code:

Phone#:

Name:

Address:

Area Code:

Phone#:

Employment Experience

1 Most recent employer:

Address:

Telephone number(s):

Position title/Job title:

Dates of employment:

Hourly Rate/Salary:

Starting: Final:

Supervisor(s):

Reason for leaving:

Work performed:

2 Employer:

Address:

Telephone number(s):

Position title/Job title:

Dates of employment:

Hourly Rate/Salary:

Starting: Final:

Supervisor(s):

Reason for leaving:

Work performed:

3 Employer:

Address:

Telephone number(s):

Position title/Job title:

Dates of employment:

Hourly Rate/Salary:

Starting: Final:

Supervisor(s):

Reason for leaving:

Work performed:

4 Employer:

Address:

Telephone number(s):

Position title/Job title:

Dates of employment:

Hourly Rate/Salary:

Starting: Final:

Supervisor(s):

Reason for leaving:

Work performed:

Applicant Please Note: Your references will be checked!

Applicant’s Statement

I certify that the answers that are 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. I release previous employers from liability for providing a complete reference.

This application for employment shall be considered active for a period of time not to exceed six months or 180 days.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means the Employee may resign at any time and the Employer may discharge the Employee at any time, with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

Employment is contingent upon a pre-employment drug test with negative results.

Date:*

/ /

Signature:*

Print This Page

Email This Page