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:____________________)