Atlanta Employment Form – Fill Out and Use This PDF

PLEASE PRINT ALL

INFORMATION REQUESTED

EXCEPT SIGNATURE

APPLICATION FOR EMPLOYMENT

DO YOU HAVE A DRIVER’S LICENSE?  Yes  No

What is your means of transportation to work? ______________________________________________________________

Driver’s license					 Operator		 Commercial (CDL)		Chauffeur
number ____________________________ State of issue _______
Expiration date ______________________
Have you had any accidents during the past three years?							How many? __________________
Have you had any moving violations during the past three years?							How Many? __________________
				OFFICE ONLY
	 Yes			 Yes		Word		 Yes
Typing	 No	_____ WPM		10-key  No		Processing		 No	_____ WPM
Personal	 Yes	PC		Other ____________________________________________
Computer	 No	Mac		Skills	____________________________________________

Please list two references other than relatives or previous employers.

Name ________________________________________		Name ____________________________________________
Position ______________________________________		Position __________________________________________
Company _____________________________________		Company _________________________________________
Address ______________________________________		Address __________________________________________
______________________________________		__________________________________________
Telephone ( )		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.

PLEASE PRINT ALL

INFORMATION REQUESTED

EXCEPT SIGNATURE

APPLICATION FOR EMPLOYMENT

MILITARY

HAVE YOU EVER BEEN IN THE ARMED FORCES?		 Yes	 No
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?			 Yes	 No
Specialty __________________________________ Date Entered			________________ Discharge Date ______________
Work	Please list your work experience for the past five years beginning with your most recent job held.
Experience	If you were self-employed, give firm name. Attach additional sheets if necessary.
Name of employer		Name of last			Employment dates	Pay or salary
Address		supervisor
City, State, Zip Code					From	Start
Phone number
					To	Final

Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of employer	Name of last	Employment dates	Pay or salary
Address	supervisor
City, State, Zip Code
		From	Start
Phone number
		To	Final
	Your Last Job Title
Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

PLEASE PRINT ALL

INFORMATION REQUESTED

EXCEPT SIGNATURE

APPLICATION FOR EMPLOYMENT

Work	Please list your work experience for the past five years beginning with your most recent job held.
experience	If you were self-employed, give firm name. Attach additional sheets if necessary.
Name of employer		Name of last	Employment dates	Pay or salary
Address		supervisor
City, State, Zip Code
			From	Start
Phone number
			To	Final
		Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of employer	Name of last	Employment dates	Pay or salary
Address	supervisor
City, State, Zip Code
		From	Start
Phone number
		To	Final
	Your last job title
Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

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 ___________________ (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 andmay 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 also understand that (1) the Company has a drug and alcohol policy that provides for preemployment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job- related physical examinations.

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.

Signature of applicant__________________________________________ Date: ___________________

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

Thank you for completing this application form and for your interest in our business.