Application for Employment

Section A: Personal Information

Name

First

Middle

Last

Desired Position Desired Position

Address

City

State/Province

Zip/Postal

Email

Phone

Section B: General

What type of position are you interested in?

What location are you applying for?

If offered a position, when are you available to start?

Desired Annual Salary/Wages

$

How were you referred to us? How were you referred to us?

Are you legally authorized to work in the United States?

Yes

No

If hired, can you provide proof of your eligibility to work in the United States

Yes

No

Are you 18 years of age or older?

Yes

No

Have you ever been convicted of a felony?

Yes

No

A yes answer will not automatically disqualify you from employment.

Have you ever applied for employment with HIGHLAND COMPUTER FORMS before?

Yes

No

Please provide the date.

Has the company ever employed you before?

Yes

No

Most recent start date

Most recent end date

Are you available to work overtime?

Yes

No

Do you have any friends or relatives working at HIGHLAND COMPUTER FORMS?

Yes

No

Please list the name(s).

Section C: Education

Highest level of education completed? Highest level of education completed?

Course of Study

Years Completed

Diploma/Degree

Section D: Military Service

Were you in the U.S. Military?

Yes

No

What branch?

Rank at time of discharge

Have you had any job-related training in the military?

Yes

No

Please describe the job-related training.

Section E: Employment History

List your last three employers starting with your most recent one.

Employer 1

Name of Company

Address

City

State/Province

Zip/Postal

Job Title

Duties

Supervisor

Title of Supervisor

Phone

Start Date

End Date

Starting Wage/Salary

$

Final Wage/Salary

$

Did you receive other compensation?

Yes

No

This could include any bonuses or commission received.

What is the total amount of additional compensation?

$

Reason for leaving?

Employer 2

Name of Company

Address

City

State/Province

Zip/Postal

Job Title

Duties

Supervisor

Title of Supervisor

Phone

Start Date

End Date

Starting Wage/Salary

$

Final Wage/Salary

$

Did you receive other compensation?

Yes

No

This could include any bonuses or commission received.

What is the total amount of additional compensation?

$

Reason for leaving?

Employer 3

Name of Company

Address

City

State/Province

Zip/Postal

Job Title

Duties

Supervisor

Title of Supervisor

Phone

Start Date

End Date

Starting Wage/Salary

$

Final Wage/Salary

$

Did you receive other compensation?

Yes

No

This could include any bonuses or commission received.

What is the total amount of additional compensation?

$

Reason for leaving?

Section F: Personal/Professional References

Do not include family members or past supervisors.

Reference 1

Name

Phone

Best Time to Call

Occupation

Reference 2

Name

Phone

Best Time to Call

Occupation

Reference 3

Name

Phone

Best Time to Call

Occupation

Section G:

Please provide an explanation of any gaps in your employment.

Section H:

Please describe any training or specialized skills.

Section I: Applicant's Statement

Please read the following statements carefully

Statement

I, the undersigned, understand that I am being considered as a potential employee of HIGHLAND COMPUTER FORMS and hereby certify that:

1. In consideration of my employment, I agree to conform to the policies and procedures of the Company. I understand that in accepting this application, HIGHLAND COMPUTER FORMS is in no way obligated to provide me with employment and that I am not obligated to accept employment if offered.

2. I understand that if I am hired, such hiring will not be for any definite period of time. Furthermore, I understand, that if I am hired, I will be an employee at-will and I can be terminated at any time, with or without cause and with or without notice.

3. I understand that my status as an at-will employee, and the terms and conditions of that employment cannot be changed except in writing and signed by the President of HIGHLAND COMPUTER FORMS.

4. I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any falsified statements on this application or omission of fact on either this application or during the pre-employment process will result in my application being rejected, or, if I am hired, in my employment being terminated.

5. I also understand that any off of employment is conditioned on the completion of pre-employment tests and documentation. I will, upon request, sign all necessary consent forms.

Signature

Clear

Date

reCAPTCHA

Office Use Only

Applicant Hired?

Yes

No

Start Date

Starting Salary/Wage

$per year/hour

Application for Employment

Section A: Personal Information

Section B: General

Section C: Education

Section D: Military Service

Section E: Employment History

Employer 1

Employer 2

Employer 3

Section F: Personal/Professional References

Reference 1

Reference 2

Reference 3

Section G:

Section H:

Section I: Applicant's Statement

Office Use Only

Federal Transparency in Coverage Rule