151 Fourmile Lane, Unit B
Canon City, CO 81212
719-275-5091 office
719-315-2727 fax
Application for Employment
Name ______Phone # ______
Last First
Address ______City ______
State _____ Zip ______SS# ______DOB ______
Currently employed? YES NO If yes, list where employed______
Current salary/wage ______Desired wage/hr______
Employment History (list from most recent to previous):
Employer name/address/phone# Dates Salary/Wage Reason for leaving
______
______
______
______
Page 1 of 3
Do you have experience with operating heavy equipment? YES NO
If yes, explain what type of equipment & how many years of experience: ______
______
______
______
List education history:
School Dates Degree/Diploma
______
______
______
______
Do you have any special skills &/or certifications to list? ______
______
Have you ever been convicted of any felony or misdemeanor involving alcohol or drugs? YES NO
Have you ever been convicted of any other felony or misdemeanor? YES NO
Were you ever discharged or forced to resign from any position for misconduct or unacceptable services? YES NO
If yes to any of the above questions, please explain. ______
______
______
______
Page 2 of 3
Would you be available to work over time &/or on Saturday’s? YES NO
Do you have a reliable vehicle? YES NO
Are you looking for: Full Time / Part Time / Whatever is available
Do you have a CO driver’s license? YES NO
REFERENCES:
Name Address & Phone # Position or Occupation
______
______
______
______
I, ______, hereby confirm that all of the information listed is correct and accurate to the best of my knowledge. If false information is given, it is YardCrafters, LLC, right to discard this application and no other considerations will be made.
______
Signature Date
Thank you for your time!
OFFICE USE ONLY
Date Received ______
Contacted by ______
Interview set ______