APPLICATION FOR EMPLOYMENT

Instructions:
Click here for the Employment Application
Print  and complete application.
Fax completed application to: 1-417-862-0661
The form below may also be printed and faxed.
Thank you!

 

Please fax completed form to: 1-417-862-0661

Name: Last _____________ First __________ Middle _________ Date __________

Street Address ______________________________________________________

City ______________________ State ____________ Zip _________________

Telephone (   ) ________________ Social Security # ____________________

Position applied for ___________________________________________________

When can you start _____________________ Desired Wage $ ______________

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis?

 [  ] Yes [  ] No

Are you looking for full time employment? [  ] Yes [  ] No

If no, what hours are you available? _______________

Have you ever been convicted of a felony? [  ] Yes [  ] No

If yes, please fully describe the circumstances: _________________________________________

_____________________________________________________

Education: School Name and Location Year Major Degree

High School _____________________________________________________

College _____________________________________________________

College _____________________________________________________

Other _____________________________________________________

_____________________________________________________

In addition to your work history, are there are other skills, qualifications, or experience we should consider:

_____________________________________________________

_____________________________________________________

Employment History: (Start with most recent employer.)

Company name _______________________

Address __________________________________ Telephone _________________

Date Started _______ Starting Wage _______ Starting Position ___________

Date Ended ________ Ending Wage _______ Ending Position ___________

Name of Supervisor ________________ May we contact? [  ] Yes [  ] No

Responsibilities _____________________________________________________

Reason for leaving _____________________________________________________

Company name _______________________

Address __________________________________ Telephone _________________

Date Started _______ Starting Wage _______ Starting Position ___________

Date Ended ________ Ending Wage _______ Ending Position ___________

Name of Supervisor ________________ May we contact? [  ] Yes [  ] No

Responsibilities ________________________________________________________

Reason for leaving ______________________________________________________

Company name _______________________

Address __________________________________ Telephone _________________

Date Started _______ Starting Wage _______ Starting Position ___________

Date Ended ________ Ending Wage _______ Ending Position ___________

Name of Supervisor ________________ May we contact? [  ] Yes [  ] No

Responsibilities _____________________________________________________

Reason for leaving _____________________________________________________

Attach additional information if necessary.

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge.
I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal.
Bayless Corporation is hereby authorized to make any investigations of my prior educational and employment history.

Signature _________________________ Date ____________________