Maria Alvarez

Name_____________________________

SAMPLE
EMPLOYMENT APPLICATION

This company is an equal opportunity/affirmative action employer. All qualified

applicants will be considered without regard to age, race, color, sex, religion, nation
origin, marital status, ancestry, citizenship, veteran status, sexual orientation or
preference, or physical or mental disability.

TCD Sample Job Application

PERSONAL
FULL LEGAL NAME
Last Name
Alavrez
______________________

First
Maria
__________________

Middle
P
_______

Social Security Number

123-45-6789

Street Address
30w071 Glenhurst Ct.
_______________________________________________________________

Home Telephone Number

N/A
(
) _____________________

City
Warrenville
__________________

Cell Phone Number

607-8662
( 630 ) _____________________

State
IL
____

Position Applied For

Referred By

Pastry Chef

Faith Jennetta

ZIP Code
60555
____________

Desired Salary

Have you ever interviewed with the company or its

No
affiliates before?
Yes

If yes, list date(s) & location(s)

Have you ever been employed by the company or its

No
affiliates before?
Yes

If yes, list date(s), job title(s) & location(s)

Do you have any relatives employed by the company or its

No
affiliates?
Yes

If yes, list date(s), job title(s) & location(s)

Are you at least 16 years old?

If under 16, do you have a work permit?

Yes No

Yes No

How did you hear about this opportunity?

What makes you qualified for this position?

Technology Center of DuPage.

Always on time, great listener, take my job

serious, hard worker.

TCD Sample Job Application

EDUCATION
& SKILLS
Check all that apply:

School

_____
High School

_____ Career & Technical Education

_____ College Coursework (Dual Credit/Articulated Credit)

Expected
Graduation
Date

Name, Street, City, State, and ZIP Code

Studies of Focus

Wheaton Warrenville South High School

High School

1993 Tiger Trl.

Wheaton, IL 60189

May, 2015

Technology Center Of DuPage

Career & Technical
Education

301 S. Swift Rd.

Addison, IL 60101

May, 2015

N/A

College
Coursework

Culinary Pastry
Chef and
Hospitality
Managment

List any activities or affiliations that you have been a part of below:

Cheese Certification
Pro-Start
CPR and Fire Safety Certification
Yearbook
List any languages, other than English, in which you are fluent? Check the appropriate letter (R = read, W = write, S =
speak).

Spanish

__________

S___
W ___
R ___

Do you have strong keyboarding skills?

Yes

_____ _____

R ___ W ___ S ___

No

Took Computer Classes in Middle School (6th-8th)

List any computer skills (Hardware/Software):

Microsoft

List any transferrable skills that would apply to this position:

TCD Sample Job Application

EMPLOYMENT HISTORY
List your employment experiences, starting with the most recent position. List month and year only.
All information must be completed. Volunteer work is applicable.
From

Employers Name

Supervisors Name

Starting Salary

Supervisors Phone Number

Ending Salary

N/A
To

Address

) ______________

City ________________ State ____ ZIP ______

Job Title

Reason for Leaving

Duties & Responsibilities

From

Employers Name

Supervisors Name

Starting Salary

To

Address

Supervisors Phone Number

Ending Salary

) ______________

City ________________ State ____ ZIP ______

Job Title

Reason for Leaving

Duties & Responsibilities

TCD Sample Job Application

EMERGENCY NOTIFICATION DESIGNATION

Person to notify in case of emergency
Name

Relationship

Patricia Alvarez

Home Address

City

30w071 Glenhurst Ct.

Mother
State
IL
______

Warrenville

Home Phone Number

N/A
(
) ___________________
Company

Cell Phone Number

956-0396
( 630 ) ___________________
Company Phone Number

Company Address

876-3260
( 630 ) ___________________
City

Ready Access

West Chicago

1815 Arthur Dr.

State
____
IL

REFERENCES (LIST THREE PERSONS NOT RELATED TO YOU WHO KNOW YOUR QUALIFICATIONS)
Name

Position/Employer

Leslee N. Ferguson

Address

Relationship

28w542 Batavia Rd.

City
Warrenville
______________________
E-mail Address

State
IL
_____

Youth Prevention Specialist

Leader

Zip
Telephone No.
60555 ( 630 ) ______________
393-7057
_______

Lferguson@outreachcommin.org

Name

Position/Employer

Juliana Chavez

Address

Relationship

1700 Molitor Rd. Apt 101

City
Aurora
______________________
E-mail Address

State
IL
_____

Zip
60505
_______

Director

Maneger

Telephone No.
433-7290
( 630 ) ______________

chalomarely@yahoo.com

Name

Position/Employer

Sarah Knupp

Address

Relationship

28w560 Ferry Rd.

City
Warrenville
______________________
E-mail Address

State
IL
_____

Zip
60555
_______

TCD

Co-Workers

Telephone No.
388-7288
( 262 ) ______________

sknupp123@gmail.com

GENERAL
Yes

No

Have you ever failed to be rehired?

Have you ever been convicted of a crime, excluding misdemeanors and summary
offenses, which has not been annulled or expunged by court? (A yes response
does not automatically disqualify your application.)

NA

May we contact your current employer for references?

TCD Sample Job Application

CERTIFICATION & AUTHORIZATION

The above information is true and correct. I understand that, in the event of my employment by the
Company, I shall be subject to dismissal if any information that I have given in this application is
false or misleading or if I have failed to give any information herein requested, regardless of the time
elapsed after discovery.
I authorize the Company to inquire into my educational, professional and past employment history
references as needed to research my qualifications for this position. I hereby give my consent to any
former employer to provide employment-related information about me to the Company and will hold
the Company and my former employer harmless from any claim made on the basis that such
information about me was provided or that any employment decision was made on the basis of such
information. I further authorize the Company to obtain any credit and consumer check.
If employed, I will be required to provide original documents which verify my identity and right to
work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The
document(s) provided will be used for completion of Form I-9.
I hereby acknowledge that I have read and agree to the above statements.

Signature

TCD Sample Job Application

Date