Company Name

Employment Application
Applicant Information
Full Name:

Hatcher
Last

Address:

Solomon

First

M.I.

Date:2/22/16

1139 Hillcrest Rd
Street Address

Phone:

Apartment/Unit #

Birmingham

Alabama

35005

City

State

ZIP Code

(205)587-7368

Date Available:

2/23/16

Email Rolltideking33@gmail.com
Social Security No.:212658978

Desired Salary:$ 100,000

Position Applied for: Lead game designer

Are you a citizen of the United States?

If no, are you authorized to work in the U.S.?

yes

Have you ever worked for this company?

no

Have you ever been convicted of a felony?

no

If yes, when?

If yes, explain:

Education
High School:
From:

Minor high school

To:

Address:2285 Minor Pkwy, Adamsville, AL 35005

Did you graduate?

College:
From:

NO

YES

NO

YES

NO

Diploma::

Address:
To:

Did you graduate?

Other:
From:

YES

Degree:

Address:
To:

Did you graduate?

Degree:

References
Please list three professional references.
Full Name: Mrs.Kameka .D Cottrell

Relationship:Teacher

Company:

Minor high school

Phone:379-4750

Address:
Full Name: Mr.Kalvin Eaton
Company:

Relationship:

Minor high school

Phone:

Address:
Full Name: Kelvin Benion
Company:

Relationship:

Minor high band

Phone:

Address:

Previous Employment
Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

2

NO

Military Service
Branch:

From:

Rank at Discharge:

To:

Type of Discharge:

If other than honorable, explain:

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:

Solomon Hatcher

Date:2/22/16