12162 S Business Park Dr, Draper, UT 84020

800-295-9295

Employment Application Form

Personal Information:
Last Name:

First Name:

Middle Initial:

Present Physical Address: (Street, City, State, Zip,)

Present Mailing Address: (P.O. Box, City, State, Zip)
Date of Birth:

Social Security No.:

Cell Phone No.:

Home Phone No.:

E-mail Address:

Are you legally authorized to work in the United States? ( ) Yes ( ) No

Have you ever been convicted of a felony? ( ) Yes ( ) No
If yes, please explain:
Have you ever worked for us before? ( ) Yes ( ) No If yes, when and where?
Position Desired:

Salary Desired:

Date available for work:

Name of person who referred you to PlusOne Company:

Education and Training:

School

Name and Location

High School

College/University

Additional
Training
Please list any skills which may be an asset to this job:

No. of
Years

Degree

Type of course/Major

Work Experience:
List your work experience beginning with your most recent position (attach additional sheet if necessary):
Dates
Name and Address of Employer
Position Held
Wages
Supervisor Name
From:
___/___

Name _________________________________

Your Job Title:

____________________

Starting:
____________

Supervisor:
____________________

Ending:
____________

Your Job Title:

____________________

Starting:
____________

Supervisor:
____________________

Ending:
____________

Your Job Title:

____________________

Starting:
____________

Supervisor:
____________________

Ending:
____________

Reason for
leaving

Address________________________________
To:
___/___

From:
___/___

Phone No.__________________ Zip ________

Name _________________________________
Address________________________________

To:
___/___

From:
___/___

Phone No.__________________ Zip ________

Name _________________________________
Address________________________________

To:
___/___

Phone No.__________________ Zip ________

Have you ever been asked to leave a job? ( ) Yes ( ) No

How many jobs have you had in

the last five years?

If yes, list details:

References
Reference (not related to you):

Company/Job Title:
Phone No.:

Address (street, city, zip)

Reference (not related to you):

Company/Job Title:
Phone No.:

Address (street, city, zip)

Reference (not related to you):

Company/Job Title:
Phone No.:

Address (street, city, zip)

Please answer the following questions:

What do you know about PlusOne as a company?
__________________________________________________________________________________________________
__________________________________________________________________________________________________

What do you know about the products we sell?

__________________________________________________________________________________________________
__________________________________________________________________________________________________

Are you currently employed? If yes, what do you like the least about your current job?
__________________________________________________________________________________________________
__________________________________________________________________________________________________

Why are you interested in sales?

__________________________________________________________________________________________________
__________________________________________________________________________________________________

What gives you confidence that you can become a top performance at PlusOne?
__________________________________________________________________________________________________
__________________________________________________________________________________________________

What do you consider to be your greatest weakness?

__________________________________________________________________________________________________
__________________________________________________________________________________________________

Why should PlusOne hire you?

__________________________________________________________________________________________________
__________________________________________________________________________________________________

Applicant is expected to submit their resume with this application.

Disclaimer and Signature:
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or
interview may result in my release.
Signature:

Date: