Personal Information

First Name: _____________________________

Middle Name: ___________________________

Last Name: _____________________________

Street Address: __________________________

City, State, Zip Code: _____________________

Phone Number: (___)_____________________

Email Address: __________________________

Have you ever applied to / worked for [Our Company] before?

[ ] Y or [ ] N
If yes, please explain (include date): ________________________

Do you have any friends, relatives, or acquaintances working for [Our Company]? [ ] Y
or [ ] N
If yes, state name & relationship: ________________________________

If hired, would you have transportation to/from work? [ ] Y or [ ] N

Are you over the age of 18? [ ] Y or [ ] N

If you are under the age of 18, do you have an employment/age certificate? [ ] Y or [ ]
N

If hired, would you be able to present evidence of your U.S. citizenship or proof of your
legal right to work in the United States? [ ] Y or [ ] N

Have you been convicted of or pleaded no contest to a felony within the last five
years? [ ] Y or [ ] N

If yes, please describe the crime - state the nature of the crime(s), when and where
convicted, and the disposition (final settlement) of the case:
________________________________________________________________

If hired, are you willing to submit to a controlled substance test? [ ] Y or [ ] N

Position and Availability

Position Applying For: ___________________________

Desired Salary: $________

Are you applying for:

 Temporary work – such as summer or holiday work? [ ] Y or [ ] N

 Regular part-time work? [ ] Y or [ ] N
 Regular full-time work? [ ] Y or [ ] N

If applying for temporary work, indicate your desired length of employment below:

Start date: ___ / ___ / ___ End date: ____ / ____ / ____

Days/Hours Available

Monday ____
Tuesday ____
Wednesday ____
Thursday ____
Friday ____
Saturday ____
Sunday ____

Hours Available: from _______ to ______

Are you available to work overtime? [ ] Y or [ ] N

If hired, on what date can you start working? ___ / ___ / ___

Are you able to perform the essential functions of the job for which you are applying,
either with / without reasonable accommodation? [ ] Y or [ ] N

If no, describe the functions that cannot be performed:

_____________________________________________________________

Education, Training and Experience

High School:
School Name: ________________________
School Address:________________________
School City, State, Zip:________________________________
Number of years completed: _______________
Did you graduate? [ ] Y or [ ] N
Degree / Diploma earned: _______________

College / University:
School Name: __________________________
School Address:________________________
School City, State, Zip:________________________________

Number of years completed: ________

Did you graduate? [ ] Y or [ ] N
Degree / Diploma Earned: __________________

Vocational School:
School Name: ________________________
School Address: ______________________
School City, State, Zip: ________________________________

Number of years completed: ________

Did you graduate? [ ] Y or [ ] N
Degree / Diploma earned: __________________

Military:
Branch: ______________________________
Rank in Military:________________________
Total Years of Service: ________
Skills/Duties: __________________________________
Related Details:________________________________

Skills and Qualifications: Licenses, Skills, Training, Awards

_____________________________________________________________

_____________________________________________________________

Do you speak, write or understand any foreign languages? [ ] Y or [ ] N

If yes, list which languages(s) and how fluent you consider yourself to be:
____________________

Employment History

You should be prepared to detail each position for the past five years and account for
any gaps in employment during that period.

Are you currently employed? [ ] Y or [ ] N

If you are currently employed, may we contact your current employer? [ ] Y or [ ] N

Name of Employer:_____________________________________
Name of Supervisor:____________________________________
Telephone Number:_____________________________________
Business Type:________________________________________
Address:_____________________________________________
City, State, Zip:________________________________________

Length of Employment (Include Dates): _____________

Salary/Hourly Rate of Pay: ____________

Position & Duties: _______________________________________________________
Reason for Leaving: _____________________________________________________

Name of Employer: _____________________________________

Name of Supervisor: ____________________________________

Telephone Number:_____________________________________
Business Type:________________________________________
Address:_____________________________________________
City, State, Zip:________________________________________

Length of Employment (Include Dates): _____________

Salary/Hourly Rate of Pay: ____________

Position & Duties: _______________________________________________________
Reason for Leaving: _____________________________________________________

May we contact this employer for references? [ ] Y or [ ] N

Name of Employer:_____________________________________
Name of Supervisor:____________________________________
Telephone Number:_____________________________________
Business Type:________________________________________
Address:_____________________________________________
City, State, Zip:________________________________________

Length of Employment (Include Dates): _____________

Salary/Hourly Rate of Pay: ____________

Position & Duties: _______________________________________________________
Reason for Leaving: _____________________________________________________

May we contact this employer for references? [ ] Y or [ ] N

References

List below three persons who have knowledge of your work performance within the last
four years. Please include professional references only.

First and Last Name: _____________________________________

Telephone Number: ______________________________________
Email Address: __________________________________________
Address:_______________________________________________
City, state, zip:__________________________________________
Occupation: ____________________________________________
Number of Years Acquainted: ______________________________

First and Last Name: _____________________________________

Telephone Number: ______________________________________
Email Address: __________________________________________
Address:_______________________________________________
City, state, zip:__________________________________________
Occupation: ____________________________________________
Number of Years Acquainted: ______________________________

First and Last Name: _____________________________________

Telephone Number: ______________________________________
Email Address: __________________________________________
Address:_______________________________________________
City, state, zip:__________________________________________
Occupation: ____________________________________________
Number of Years Acquainted: ______________________________
Sample Job Application Letter

John Donaldson
8 Sue Circle
Smithtown, CA 08067
909-555-5555
john.donaldson@emailexample.com

Date

George Gilhooley
XYZ Company
87 Delaware Road
Hatfield, CA 08065

Dear Mr. Gilhooley,

I am writing to apply for the programmer position advertised in the Times Union.
As requested, I am enclosing a completed job application, my certification, my
resume, and three references.

The opportunity presented in this listing is very interesting, and I believe that my
strong technical experience and education will make me a very competitive
candidate for this position. The key strengths that I possess for success in this
position include:

 I have successfully designed, developed, and supported live use

applications

 I strive for continued excellence

 I provide exceptional contributions to customer service for all customers

With a BS degree in Computer Programming, I have a full understanding of the

full lifecycle of a software development project. I also have experience in learning
and excelling at new technologies as needed.

Please see my resume for additional information on my experience.

I can be reached anytime via email at john.donaldson@emailexample.com or my

cell phone, 909-555-5555.

Thank you for your time and consideration. I look forward to speaking with you
about this employment opportunity.
Sincerely,

Signature (for hard copy letter)

John Donaldson

Sample Email Letter of Application

Subject: FirstName LastName - Web Content Manager Position

Dear Contact Person:

I'm writing to express my interest in the Web Content Manager position listed
on Monster.com. I have experience building large, consumer-focused health-
based content sites. While much of my experience has been in the business
world, I understand the social value of the non-profit sector and my business
experience will be an asset to your organization.

My responsibilities included the development and management of the site's

editorial voice and style, the editorial calendar, and the daily content
programming and production of the website.

I worked closely with healthcare professionals and medical editors to help them
provide the best possible information to a consumer audience of patients. Also, I
helped physicians learn to utilize their medical content to write user-friendly,
readily comprehensible text.

Experience has taught me how to build strong relationships with all departments
at an organization. I have the ability to work within a team as well as cross-team.
I can work with web engineers to resolve technical issues and implement
technical enhancements, work with the development department to implement
design and functional enhancements, and monitor site statistics and conduct
search engine optimization.

Thank you for your consideration.

Signature (hard copy letter)