APPLICATION FOR EMPLOYMENT

Applicant to complete all information requested. (Please Print)

In compliance with Federal and State equal employment opportunity laws, qualified applicants are 

considered for all positions without regard to race, color, religion, sex, national origin, age, martial status, 

veteran status, non-job related disability, or any other protected group status. 

PERSONAL INFORMATION

Date of Application:_____________________________ 

Position(s) Applying for:______________________________________________________ 

Name:_____________________________________________________________________ 

 First Middle Last

Social Security Number:___________________________________ 

Present Address:____________________________________________________________ 

Number Street City State Zip 

Previous Address: :__________________________________________________________ 

 Number Street City State Zip 

Telephone Number: (______)___________________ Or (______)___________________ 

Email Address:_____________________________________________________________ 

Do you have a legal right to be employed in the United States? Yes (proof required) No 

Are you over the age of 18? Yes No 

Have you ever been employed with us before? Yes No 

If Yes, give date: _________________________ 

Are you currently employed? Yes No 

May we contact your present employer? Yes No 

Date available for work: _________/__________/___________ 

What is your desired salary range? $_____________________ 

Are you available to work: Full-Time Part-Time Temporary 

Can you travel if a job requires it? Yes No 

Do you have a valid driver’s license? Yes No 

Have you ever been convicted of a felony? Yes No 

12

EDUCATIONAL BACKGROUND

Type of School Name & City Did you 

Graduate?

Course or Major 

High School 

College 

Technical School 

Other (specify)

EMPLOYMENT EXPERIENCE

Specialized Skills:

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

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________ 

Other Skills:

 Terminal PC/MAC Spreadsheet Word Processing WPM=________ 

Production/Mobile Machinery (list):_____________________________________________ 

_________________________________________________________________ 

Other Specialized Skills:_______________________________________________________ 

_________________________________________________________________ 

List professional, trade, business, or civic activities and office held. (You may exclude membership 

which would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status.)

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________ 

State any additional information you feel may be helpful to us in considering your 

application.

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________ 3

EMPLOYMENT HISTORY

Start with your present or last job. Include any job-related military service assignments and volunteer 

activities. You many exclude organizations which indicate race, color, religion, gender, national origin, 

disabilities, or other protected status. 

Employer Work Performed 

Address 

Telephone Number(s) 

Job Title Supervisor 

Reason for Leaving 

 Dates Employed Hourly Rate/Salary 

From To Starting Final 

Employer Work Performed 

Address 

Telephone Number(s) 

Job Title Supervisor 

Reason for Leaving 

 Dates Employed Hourly Rate/Salary 

From To Starting Final 

Employer Work Performed 

Address 

Telephone Number(s) 

Job Title Supervisor 

Reason for Leaving 

 Dates Employed Hourly Rate/Salary 

From To Starting Final 4

REFERENCES

1. _______________________________________________________ (______)____________________ 

(Name) (Phone Number) 

 _____________________________________________________________________________________ 

 (Address) (City) (State) (Zip) 

_______________________________________________________ 

 (Relationship to Applicant) 

2. _______________________________________________________ (______)____________________ 

(Name) (Phone Number) 

 _____________________________________________________________________________________ 

 (Address) (City) (State) (Zip) 

_______________________________________________________ 

 (Relationship to Applicant) 

3. _______________________________________________________ (______)____________________ 

(Name) (Phone Number) 

 _____________________________________________________________________________________ 

 (Address) (City) (State) (Zip) 

_______________________________________________________ 

 (Relationship to Applicant) 

APPLICANT’S STATEMENT

I certify that answers given herein are true and complete. I authorize investigation of all statements 

contained in this application for employment as necessary to arrive at an employment decision. 

This application for employment shall be considered active for a period of time not to exceed 60 days. Any 

applicant wishing to be considered for employment beyond this time period should inquire as to whether or 

not applications are being accepted at that time. 

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment 

relationship with The Steam Team, Inc. is of an “at will” nature, which means that the Employee may resign at any 

time the Employer may discharge 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 

such change is specifically acknowledged in writing by an authorized executive at The Steam Team, Inc. 

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 Steam Team, Inc. 

_______________________________________________________ ____________________________ 

 Signature of Applicant Date 

Human Resources Department Use Only 

Positions (s) Applied for is Open: Yes No

Action Taken: Documents Received:

 Letter (Date Sent:___________________) Resume

 Phone Call (Date Called:___________________) Letter(s) of Recommendation 

 Interview (Date Interviewed:__________________)

 Provisional Criminal Reference Check (Date Pulled:____________________)