Professional Documents
Culture Documents
Application
Application
Date__5/23/2017__________________________________________________
Fill in upon employment
Name Jenkins Alexis R
Last First Middle Initial Social Security Number
EDUCATION
Name and Location of School No. of Years Did You Subjects Studied
Attended Graduate?
4 anticipated Math, Science, English, History,
High School __Holt High School, Holt Mi German
College n/a
College _____n/a____________________
Trade, Business or
Correspondence ___n/a_________________
School
Other _____________________________
GENERAL
Subjects of Special Study or Research Work CPR, First Aid and AED certifies
What Foreign Languages Do You Speak fluently? German Read? German Write? German
Date Name, Address and Phone of Position Salary Why did you leave?
Month and Year Employer
From_8-16_____ Maurices, 2165 Marketplace Sales $9.15/hour Varsity Tennis season
To 2-17 Blvd Lansing Mi Associate
From___________
To
From___________
To
From___________
To
From___________
To
REFERENCES: Give below the names of three persons not related to you, whom you have known at least one year.
Name Address Occupation Years Acquainted
1 Patrick Kayser 4850 Hummingbird Lane Holt Mi Architect 42
PHYSICAL RECORD: Do you have any physical condition which may limit your ability to perform the job applied for?
Explain:
no
In Case of
Emergency Notify Rose Jenkins 304 East Rd (630)4846256
Name Address Phone No.
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of
facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may,
regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice.
Interviewed By Date
REMARKS:
Neatness Character
Personality Ability
Hired For Dept. Position Will Report Salary
Approved: 1. 2. 3.
Employment Manager Dept Head General Manager
Adapted with permission for student practice from Form M660-26NR Wilson Jones Company