b'Legally Gather RelevantInformation from Job CandidatesEmployment History Employment History ComplyRightStarting with your most recent employer, provide the following information. You may include any verified work performed on a volunteer basis. Starting with your most recent employer, provide the following information. You may include any verified work performed on a volunteer basis. BestEmployerTelephone # EmployerTelephone # State-Specific ApplicationStreet address() StateStreet address() StateCalifornia SellerStarting job title/final job titleYour Company Name CityMonthYear MonthYear Starting job title/final job titleCityMonthYear MonthYear for Employment Application for Employment Your Company NameDates employedDates employed Application for Employment Immediate supervisor and title (for most r Street Address May we contact for reference?/to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / Please Print Street AddressWhy did you leave? ecent positiStat Why did you leave? E-mail: Gather the job-related information you need withoutEqual acc l t e f s o s to p i rograms, ser c v t ic i es an a d e l a mp c l l oy d ment op i portuni n ties is av l s a o il c ab t le to a i i it ll per c sons wi p t r h e o i ut re City,i State ZIP i olor, dis it l ability, l itary Please Print City, on held)e ZIP Yes No Later E-mail: Yes No Lateru s g e enet o ic in d l e t r a mat t ion, r c eprod l r u r d ig ve he it c r th d t ecis i ion ma i k t in if g, ge r der, g l e a n b d l e s r id r ent d t t y, g o e c nde e r ex h a r ss l io ta gar x d t t o age, an e ce s st e r t y, c l al c r ond y t ion, mil ion, Summarize the type of work performed and job responsibilities. Summarize the type of work performed and job responsibilities. crossing into illegal territory. These specific applicationsor vete c ran sat r u e s, national o b in, rae (in a fe u d es tra o ts hist h o l ic t a p ly as dica ia ta e t d w h ra a e, s x uc al o s ha n, mar ur al statu r s, m c dic e hairst c es), reigEqual access to programs, services and employment opportunities is available to all persons without regard to sex (including pregnancy,fe x (in l, s u at s p gnany, ch r il e a r t v r ir i th, b ro e ce s s ec e l o in l g, an u d/or re t aed me l if e s l con s D l ions), s e i n u s, app en l ir te ra t e l q e and p l t o a te o o a v b is po t te n e ed b l yions sexual orientation and gender identity), race, color, religion, na d you like most about your position? What did you like most about your position? dera e, and/or local law.What di tional origin, citizenship, age, disability, genetic information, or any other basis protected by federal, state, and/or local law.What were the things you liked least about the position? What were the things you liked least about the position? are available for every state and the District of Columbia,In accrdance w h the Am p e t icans w r h Disbil o t v es Act an it d/or ap te ic ia ouc e and l art l law . Ex ic e tion, or any oher bs e accommodatfor the appiction and/or in ic te io ew p oces s shud n g wr y t e n e Human Re ying t e s te ep t o m or t t t s amp ants r ea uiring r e acc t na odaios in r cude In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonablemaking a change to the ap rpe n p ing sp s; pr iz idin qipm t e n ma r m r od s in an a t rnae f d ma ns. uch a s of r il sonab e prin mm udio rcoding; accommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonableTelephone # EmployerTelephone #accommodations include making a change to the application process; providing written materials in an alternate format such as braille,() StateStreet address() Stateand are carefully worded to include the correct languagesing a sign language inte ; us ia ed e ; o e ing cn io s b e, larg , or aEmployer large print or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions. CityCity Street address Starting job title/final job titleDates employedMonthYear MonthYear Starting job title/final job titleDates employed MonthY ear MonthYear and proper legal disclosures.Sim onMay we contact for reference?/to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / Name __________________________________________________________________ Applicant ID #AddressLastDeborahStreetFirstMiddle A2451LastFirstImmediate supervisor and title (for most recent position h pp E-mail: 733 Main StreetHollywoodFL 33345Name __________________________________________________________________A eld)licant ID # _____________________ Yes No Later E-mail: Yes No Later__________________________________________________________________________________________________Middle () City_____________________Why did you leave? Why did you leave? Telephone # _________________ Cellular/Other Phone # ________________ E-mail Address ____________________________Address __________________________________________________________________________________________________954 554-1234Telephone # _________________Cellular/Other Phone # ________________ E-mail Address ____________________________ . Summarize the type of work performed and job responsibilities. Complies with the June 2020 U.S. Supreme CourtSim StateZIP CodeStreetCityStateZIP Code() () d job responsibilities()Referral Source Marketingon@ aol.comSummarize the type of work performed an Position(s) applied for _____________________________________________________ Date of application __________________What did you like most about your position? / /Position(s) applied for _____________________________________________________ Date of application __________________ What did you like most about your position?Referral Source(e.g., Walk-in, Job Posting, Companys Website, etc.)_________________________________________________________ What were the things you liked least about the position? decision on LGBTQ discrimination in the workplace (e.g., Walk-in, Job Posting, Companys Website, etc.) 3 14 2021What were the things you liked least about the position? / /If necessary, best time to call you is : PM Will you travel if job requires it? Yes No Telephone # Street address() StateIf necessary, b_________________________________________________________EmployerAMEmployerTelephone # HomeCellular/Other ______________ Other than time off for reasons related to your religion, a disability,() StateCityAsks probing job-related questions including skills, est time to call you is ______________ : Will you relo Street addressCity HomeCellular/Other 2 00AMYes No Yes No or a medical condition, are there any days or times when you areDates employedMonthYear MonthYear Starting job title/final job titleDates employedMonthY ear MonthYearPM cate if job requires it? . May we contact you at work? .Starting job title/final job titleble to work?___________________________________ /to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / employment history and reasons for leaving, and alsoMay we contact you at work? . No Will you travel if job requires it? unavailaIf yes, work number and best time to call: AM ____________________________________________________ May we contact for reference?E-mail: E-mail: If yes, work number and best time to call:Yes AM Other than time off for reasons related to your religion, a disability,________________________________ ______________ Will you work overtime if required? .Yes No Yes No Later Why did you leave?YesNoLater details gaps in historyYes No( ) : PM d title (for most recent position held)Immediate supervisor an________________________________ ______________ : or a medical condition, are there any days or times when you are ( )If you are under 18 and it is required,Why did you leave? If no, please explain:_______________________________ If you are under 18 and it is required, PM unavailable to work?can you furnish a work permit? N/A Yes No f work performed and job responsibilities. Summarize the type of work performed and job responsibilities.Summarize the type o________________________________________________ can you furnish a work permit? N/AYes No ____________________________________________________If no, please explain:_______________________________ Are you able to perform the essential functions of the job for whichWhat did you like most about your position? Complies with all federal and state laws If noHave you submitted an application here before? Yes No you are applying (with or without reasonable accommodation)?What were the things you liked least about the position? , please explain:________________________________ ____________________________________________________What did you like most about your position?T ti esigned to elicit information about an applicant\'s disability.Have you submitted an application here before? Yes No Will you work overtime if required? .Yes NoIf yes, give date(s) and position(s):____________________ Phleisa sqeu deos noontipsr onvoitd deh einthfoerrm acatcioomnm aobdouatti othne i se xniestceensscaer yo.fTah edsisea i bsiliuteys,pmaartyi cbuel arTelephone # EmployerTelephone #What were the things you liked least about the position?Employeraccdormessed at a later stage to the extent permitted by law. s () Includes disclosures protecting employer from liabilitymodation or w If yes, give date(s) and position(s):If no, please explain:_________________________________ ________________________________________________ ad _____________________ ____________________________________________________ress Yes No Need more information about the () StateStreet addressCityState Have you ever been employed here before? .Yes N d o City Street ad________________________________________________From ____________ To ______________ al job title jobs essential functions to respondto Have you ever been employed here bYes No Are you able to perform the essential functions of the job for which If yes, give dates:/ / / / Drivers license number required if driving may be required in theDates employedMonthYear MonthYear Starting job title/final job titleDates employedMonthY ear MonthYear Authorizes employment referencesStarting job title/finto / Immediate supervisor and title (for most recent position held)May we contact for reference?/ E-mail: / If yes, give dates: Fromefore? .you are applying (with or without reasonable accommodation)?Is this application a request for reemployment following an extendedjob for which you are applying: / ____________ To/ / This question is not designed to elicit information about an applicant\'s disability. Please Immediate supervisor and title (for most recent position held)May we contact for reference?E-mail:military leave of absence from this company? .Yes No ____________________________________State __________ Yes No Later Why did you leave? Yes No LaterIf yes, additional information may be requested. Why did you leave?Yes No Includes a ComplyRight guide to help you / / ______________ do not provide information about the existence of a disability, particular accommodation, Have you ever been bonded? .Is this application a request for reemployment or whether accommodation is necessary. These issues may be addressed at a later stage Are you lawfully authorized to work Summarize th Have you entered into an agreement with any former employer or. Summarize the type of work performed and job responsibilities. to the extent permitted by law.in the United States? Yes No e type of work performed and job responsibilities mpetition agreement) that might, in anyWhat did you like most about your position? screen and interview candidates the right way f following an extended military leave of absence Yes NoYesNoNeed more information about theother party (such as a nonco rom this company? ./ / w ost about your position?Yes No If yes jobs essential functions to respondWhat did you like m ay, restrict your ability to work for our company?. ., additional information may be requested. Drivers license numbDate available for work .______________What is your desired salary range or hourly rate of pay? What were the thin If yes, please explain: _______________________________ What were the things you liked least about the position? Are you lawfully authorized to work in er required if driving may be required in the gs you liked least about the position?$ _______________________Per _________________________________________________________________ Page 2 Page 2 DescriptionItem #Price the United States? Yes No job for which you are applying: ________________________________________________Date available for work ____________________________________Type of employment desired: Full-Time Part-Time NOTE TO RHODE ISLAND APPLICANTS: This company is subject to the states workers compensationEducational Co-Op Seasonal Temporary laws (Chapter 29-38) unless otherwise noted below (employer to list applicable exemptions): StandardLD2-A2179$71.95.______________ Have you ever been b State __________What is your desired salar / / onded? .Yes No____________________________________________________ $ y range or hourly rate of pay?Will you relocate if job requires it?Yes No ____________________________________________________ ComplyRight DownloadableLD2-A2179DL$43.95 Typ_______________________ Per _________________ Have you entered into an agreement with any former employer or e of employment desired: Full-Time Part-Time other party (such as a noncompetition agreement) that might, in any AN EQUAL OPPORTUNITY EMPLOYER Page 1 50-State Compliant Job Application PersonalizedLD2-A2179I$82.95 DownloadableEducational Co-Op Seasonal Temporary way, restrict your ability to work for our company? Yes NoIf yes, please explain:_______________________________Long Form; 4 pagesPrice per pkg/50. Size: 17" x 11".________________________________________________If you have businesses in more than one state, these applications arePersonalize up to 4 lines.AN EQUAL OPPORTUNITY EMPLOYERthe best to get the job-related information you need. Theyre attorneyPage 1Your Company Name developed and carefully worded to include the correct language andEmployment History Employment History(continued)Street Address Starting with your most recent employer, provide the following information.Explain any gaps in your employment, other than those due to personal illness, injury, or disability. _____________________________Application for Employment City, State ZIP proper legal disclosures required by all federal and state laws. EmployerTelephone # ____________________________________________________________________________________________________________Please Print ABC, Inc. 954555-1212 State____________________________________________________________________________________________________________() Street addressCity 222 Stirling WayHollywoodFL33345Equal access to programs, services and employment opportunities is available to all persons without regard to sex (including pregnancy, sexualStarting job title/final job titleDates employedMonthYear MonthYear ____________________________________________________________________________________________________________orientation and gender identity), race, color, religion, national origin, citizenship, age, disability, genetic information, or any other basisContains mandatory disclosures for all 50 states Marketing3/ 01792017Yes Noprotected by federal, state, and/or local law.Immediate supervisor and title (for most recent position held)May we contact for reference? 2 to/ If not addressed on previous page, have you ever been fired or asked to resign from a job? . E-mail:In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable accommodationsMs. Taylor Yes No Later If yes, please explain:_______________________________________________________________________________________for the application and/or interview process should notify the Human Resources Department. Examples of reasonable accommodations includeComplies with the June 2020 U.S. Supreme Court decision Why did you leave?________________________________________________________________________________________________________making a change to the application process; providing written materials in an alternate format such as braille, large print or audio recording;Location reasonsusing a sign language interpreter; using specialized equipment; or modifying testing conditions. Summarize the type of work performed and job responsibilities.on LGBTQ discrimination in the workplace What did you like most about your position?________________________________________________________________________________________________________Name _______________________________________________________________________________________________________ What were the things you liked least about the position?________________________________________________________________________________________________________LastFirstMiddleAddress _____________________________________________________________________________________________________ Excludes criminal questions in compliance with ban the box laws EmployerTelephone # Skills and QualificationsStreetCityStateZIP CodeE-mail address _________________________________________________________________ Phone () Street address() StateSummarize any special training, skills, languages, licenses, and/or certificates that may assist you in performing the position for which you are applying:________________________ City ____________________________________________________________________________________________________________Position applied for _ ____________________________________________________________Shift preferred123Any Excludes salary history questions in compliance with the salaryStarting job title/final job titleDates employed MonthYear MonthYear ____________________________________________________________________________________________________________Special training or skills (languages, machine operation, etc.) that would benefit you in the job for which you are applying: Immediate supervisor and title (for most recent position held)May we contact for reference?/to / ____________________________________________________________________________________________________________history ban and equal pay laws Yes No Later E-mail:___________________________________________________________________________________________________________________________ Why did you leave? Computer Skills(Include software titles and level of experience, such as basic, intermediate, or advanced.)___________________________________________________________________________________________________________________________Word Processing _________________________Level: _____ Internet ________________________________Level: ______ ___________________________________________________________________________________________________________________________ Includes a ComplyRight guide to help you screen and interviewSummarize the type of work performed and job responsibilities.Spreadsheet _____________________________Level: _____ Other __________________________________Level: ______ Would you accept full-time work?Yes NoWould you accept part-time work? YesNo candidates the right way What did you like most about your position?Presentation____________________________Level: _____ Other __________________________________Level: ______ On what date would you be available for work? ________________________________ What were the things you liked least about the position?E-mail _________________________________Level: _____ Other __________________________________Level: ______Have you ever been employed here?Yes NoIf yes, dates:_________________________________________________________ EmployerTelephone #Yes No () Educational BackgroundAre you lawfully authorized to work in the United States? If you are under 18 years old, can you furnish a work permit if required?N/A Yes No DescriptionItem #Price Street addressCityStateStarting with your most recent school attended, provide the following information.# of YearsGPAAre you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation)?Starting job title/final job titleDates employedMonthYear MonthYear School (include City and State) Completed Completed Class Rank Major/MinorThis question is not designed to elicit information about an applicants disability. Please do not provide information about the existence of a disability,Short FormStandardLD2-A0374 $58.95 Immediate supervisor and title (for most recent position held)May we contact for reference?/to /Diploma GEDparticular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law. E-mail:______________________Certifi on __________________DegreecatiYesNoNeed more information about the jobs essential functions to respond.Yes No LaterOther________________________ Notice to Rhode Island applicants: This Company is subject to the states workers compensation laws (Chapters 29-38) unless otherwise noted below: Fill-and-Save LD2-A0374CFL$28.95 Why did you leave? GEDDiplomDegree a______________________ cation __________________Certifi_____________________________________________________________________________________________________________________________________ Personalized LD2-A0374I$68.95 Summarize the type of work performed and job responsibilities. Other________________________(Employer to list applicable exemptions)Diploma GED What did you like most about your position? Degree Starting with your most recent school attended, provide the following information. # of YearsCompleted GPA Major/Minor Long FormStandardLD2-A0019 $71.95 What were the things you liked least about the position? Telephone #cati ComplyRight Job Educational Background Certifi ______________________ on __________________ Other________________________School (include City and State) Completed Class Rank Employer Degreea______________________ Diplom GED Diploma GEDFill-and-Save LD2-A0019CFL$33.95 Street address() State Applications comply Certification __________________ Degree ______________________ City Other________________________Certification __________________ Other________________________ Personalized LD2-A0019I $82.95 Starting job title/final job titleDates employedMonthYear MonthY ear ReferencesGEDImmediate supervisor and title (for most recent position held)May we contact for reference?/to / If not applicable, list three school or personal references who are not related to you. with the U.S. Supreme Degree a______________________Diplom List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. Certification __________________ E-mail:Other________________________a______________________ Price per pkg/50. Short form: 8" x 11". Long form: 17" x 11". Why did you leave? Yes No Later NameTitleRelationshipTelephone E-mail# of Ywnear s Degreecati GEDPersonalize up to 4 lines.Summarize the type of work performed and job responsibilities.to You() Court decision on Diplom on __________________ KnoCertifi Other________________________Diplom GED Degree a______________________ cation __________________What did you like most about your position? () LGBTQ discriminationCertifiOther________________________Fill-and-Save item What were the things you liked least about the position? Page 2 Page 3 () in the workplace.Short Form; 2 pages14 WORKPLACE MANAGEMENTHIRING HRDIRECT.COM800.999.9111 15'