Your Name

Employment Application

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You may also email your resume to: 4jcaudio@bellsouth.net

	Your Name:
	Address:
	Phone Number:
	Email Address:
	Social Security Number:
	How would you like to be contacted?	Email Phone
	Are you a citizen of the United States?	Yes No
	Have you ever been convicted of a felony?
	What position are you applying for?
	What is you desired pay?
	Where did you attend high school?
	Select the highest grade level completed:
	Dates attended:
	College attended?	Yes No
	Degree earned?	Yes No
	Dates attended:
	Please list 3 professional references, their respective companies, and phone numbers:

	Please list your previous employment history of your last 3 jobs starting with your most recent: Employer #1	dates worked: to Salary: Reason for leaving:
		dates worked: to Salary: Reason for leaving:
	May we contact your preevious employer for a reference?	Yes No

	Employer #2:	dates worked: to Salary: Reason for leaving:
		dates worked: to Salary: Reason for leaving:
	May we contact your preevious employer for a reference?	Yes No


	Employer #3	dates worked: to Salary: Reason for leaving:
		dates worked: to Salary: Reason for leaving:
	May we contact your preevious employer for a reference?	Yes No


	Why do you want to work at JC Audio?	Please type response here.

You may also email your resume to: 4jcaudio@bellsouth.net