Name (Last, First, Middle, Maiden)
Present address ( Number, Street, City, State,
Zip)
How long?
If under 18, please list age
Social Security No.
Telephone
Position applied for
Salary desired
Hours/Days
available to work:
No Preference
How many hours can you work weekly?
Can you work nights?
Yes No
Are you willing
to travel ? Yes
No What percentage are you willing to travel?
Employment
desired
Full-Time Only
Part-Time Only
Full-or part-time
When available to start?
EDUCATION
Name of High School
Address
Number
of years completed
Major
Graduated
Yes
No
College
Professional School
Business or Trade School
Name
Address
Number
of years completed
Major
Degree
College
Professional School
Business or Trade School
Name
Address
Number
of years completed
Major
Degree
College
Professional School
Business or Trade School
Name
Address
Number
of years completed
Major
Degree
HAVE
YOU EVER BEEN CONVICTED OF A CRIME?
No Yes
If yes, explain number of conviction(s), nature of offense(s) leading to
conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed,
and type(s) of rehabilitation.
COMPUTER
SKILLS
Please list perceived skill level in the following programs rated from 1-5 with
5 being expert:
1 2
3
4 5
Excel
1
2
3 4
5 Word
1
2
3 4
5 PowerPoint
1
2
3 4
5 Access
1
2 3
4
5 PeopleSoft
1
2
3
4
5 Visual Basic
1
2
3 4
5 Visio
1
2 3
4
5 Legacy
1
2 3
4
5 Oracle
1
2 3
4
5 SAP
Other Software/Databases and your skill level:
Personal Computer
Yes No
PC
Mac
REFERENCES
Please list two references other than
relatives or previous employers.
REFERENCE
1
Name
Position
Company
Address
Telephone
REFERENCE
2
Name
Position
Company
Address
Telephone
An application form sometimes makes it difficult for an individual to
adequately summarize a complete background.
Use the space below to summarize
any additional information necessary to describe your full qualifications for
the
specific position for which you are applying.
MILITARY
Have you ever been
in the Armed Forces? No
Yes
Are you now
a member of the Reserves or National Guard?
No
Yes
Specialty
Date Entered Discharge
Date
WORK
EXPERIENCE
Please list your work experience for the past ten years beginning with your most
recent job. If you were self-employed, give firm name.
MOST
RECENT JOB
Name of employer
Address, City, State,
Zip Code, Phone number
Name of last supervisor
Employment dates
Pay or salary
Your
last job title
List the
jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Reason for leaving (be specific)
PREVIOUS
JOB
Name of employer
Address, City, State, Zip Code, Phone number
Name of last supervisor
Employment dates
Pay or salary
Your last job title
List
the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Reason for leaving (be specific)
PREVIOUS
JOB
Name of employer
Address, City, State,
Zip Code, Phone number
Name of last supervisor
Employment dates
Pay or salary
Your last job title
List
the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Reason for leaving (be specific)
PREVIOUS
JOB
Name of employer
Address, City, State,
Zip Code, Phone number
Name of last supervisor
Employment dates
Pay or salary
Your last job title
List
the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Reason for leaving (be specific)
PREVIOUS
JOB
Name of employer
Address, City, State,
Zip Code, Phone number
Name of last supervisor
Employment dates
Pay or salary
Your last job title
List
the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Reason for leaving (be specific)
PREVIOUS
JOB
Name of employer
Address, City, State,
Zip Code, Phone number
Name of last supervisor
Employment dates
Pay or salary
Your last job title
List
the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Reason for leaving (be specific)
May we contact your present employer?
Yes No
Did you complete this application yourself?
Yes No
If not, who did?
PLEASE READ CAREFULLY
APPLICATION FORM WAIVER
In
exchange for the consideration of my job application by Capistrano Group Inc.
(hereinafter called “the Company”), I agree that: Neither the acceptance of this
application nor the subsequent entry into any type of employment relationship,
either in the position applied for or any other position, and regardless of the
contents of employee handbooks, personnel manuals, benefit plans, policy statements,
and the like as they may exist from time to time, or other Company practices,
shall serve to create an actual or implied contract of employment, or to confer
any right to remain an employee of, or otherwise to change in any respect the
employment-at-will relationship between it and the undersigned, and that relationship
cannot be altered except by a written instrument signed by the President /General
Manager of the Company. Both the undersigned and The Company, may end the employment
relationship at any time, without specified notice or reason. If employed, I understand
that the Company may unilaterally change or revise their benefits, policies and
procedures and such changes may include reduction in benefits.
I
authorize investigation of all statements contained in this application. I understand
that the misrepresentation or omission of facts called for is cause for dismissal
at any time without any previous notice. I hereby give the Company permission
to contact schools, previous employers (unless otherwise indicated), references,
and others, and hereby release the Company from any liability as a result of such
contract.
I
understand that, in connection with the routine processing of your employment
application, the Company may request from a consumer reporting agency an investigative
consumer report including information as to my credit records, character, general
reputation, personal characteristics, and mode of living. Upon written request
from me, the Company, will provide me with additional information concerning the
nature and scope of any such report requested by it, as required by the Fair Credit
Reporting Act.
I
further understand that my employment with the Company shall be probationary for
a period of sixty (60) days, and further that at any time during the probationary
period or thereafter, my employment relation with the Company is terminable at
will for any reason by either party.
