SAMPLE EMPLOYMENT APPLICATION ACTIVITY Directions: Read the application tips in Career Choices in NC. Fill out the application below according to the tips given in the article. APPLICATION FOR EMPLOYMENT

Social Security Number _____ - _____ - _____

Name:

Phone Number: (

)

Address (Referred By:)

Employment Desired Position

Education

Date You Can Start

Name and Location of School

Salary Desired Circle Years Completed

High School

1 2

3

4

College or Business School

1 2

3

4

Did You Graduate?

Degree (s) Major/Subject

Date

‰ YES ‰ NO ‰ YES ‰ NO

Special skills or courses taken:

Previous Employers (starting with the most recent employment) Current or Last Employer:

Supervisor

Address From (Month, Year)

Phone No. ( To (Month, Year)

)

Ending Salary $

Job Duties:

Employer:

Supervisor

Address From (Month, Year)

Phone No. ( To (Month, Year)

)

Ending Salary $

Job Duties:

Employer:

Supervisor

Address From (Month, Year)

Phone No. ( To (Month, Year)

)

Ending Salary $

Job Duties:

References Name

Address

Phone No.

Years Known

The states above are true to the best of my knowledge. I understand false information on this form could be cause for dismissal. Date _________________________________

SOICC – NC’s Career Resource Network

Signature ___________________________________________________________________

JOB SEARCH

112