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 Please Print Street AddressApplication 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 /Why did you leave? ecent positiStat Why did you leave? E-mail: Gather the job-related information you need withoutu r Eq il ual acc l e f l s o s t t o p i r f i ogr d ams, s l e t r a v l r ic i e e s an l i d e e t mp it e loy i i m e i e e l nt op t p i x i o p r r tun s ities is av l i l t a l il ie r a n b t l r e to a l r l r l p d e t r t s i a ons w e d it i h t o y u l Cit l l r y,i l Statee l ZIP l l t y, c a l o t l r o e r, disa c bilit r y, n aw.Please Print City, on held)e ZIP Yes No Later E-mail: Yes No LaterSummarize the type of work performed and job responsibilities. Summarize the type of work performed and job responsibilities. crossing into illegal territory. These specific applicationsg a e c netic in d c r r ma r t t ion, gend r er, gende s r id e en s t a y, g t a nder e t u i c t esion, mar xt al s t atus, me ec ic v l c t o h n irs tio s t regar t d t t o age, an r ce c s a t u r at t us, nat o ional o o igin, o h k e (in t cues t s ats histo p ic ic ly as e s o t cia e e s d w r l th race, s f r io h as ha x ir te d b i r f u s e and p e ot r an a m e ha r ba p n, mil e t r ar e y o l r vete d an s o des p da gnany,cl cal l s Equal access to programs, services and employment opportunities is available to all persons without regard to sex (including pregnancy,c r t dbir r h, bea io t ee h ing, and/or r at o d m b d il ic u l con o d ns), se p ual o e st ation, o oc y o aws, ap es), r o igion, sex (in r , s e, and/or lsexual orientation and gender identity), race, color, religion, na d you like most about your position? What did you like most about your position?What di tional origin, citizenship, age, disability, genetic information, or any otherIn accodan ic e w u h t h e A e me r r e e a ans w r h Dis e s sho v e s Act and/or ap te ica y ou ate and l art n l l i nt. E s x . uc is p t ec e ed by f e e r so t nabe acc io mmo r datio e 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,f sin he app a g n and/or in ic t t v io w pr c c s; po d n g w y the Human Re ces Dep e icans rquiring raIn accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonablemaing a change to te ap r n p in o ciaiz idin quipm t e e n n ma r m rias in an a s t in nae for t mat s ampes of r il asonabe accmmo ud t io r n e s in d udaccommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonableTelephone # EmployerTelephone # g a sign lan age intrp e; u g sp d e t; o o ing tet g cod ion h as ba e, large pin, or a co ing; Employeraccommodations 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 language 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 employedMonthY ear MonthYear Starting job title/final job titleDates employedMonthY ear MonthYear and proper legal disclosures.Sim on/to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / Name __________________________________________________________________ Applicant ID #AddressLastDeborahStreetFirstMiddle A2451733 Main StreetHollywoodFL 33345Name __________________________________________________________________A eld)licant ID # _____________________ May we contact for reference?E-mail: Yes No Later E-mail:LastFirstImmediate supervisor and title (for most recent position h pp Yes No Later __________________________________________________________________________________________________Middle () City_____________________Address __________________________________________________________________________________________________ Why did you leave?Why did you leave? Telephone # _________________Cellular/Other Phone # ________________ E-mail 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() () Referral S Marketingon@ aol.com()Summarize the type of work performed and job responsibilities. 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 ource(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 00AM 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? . YesNoMay 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 also unavaila May we contact you at work? . No Will you travel if job requires it? Yes If 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? . YesNo Yes No Later Why did you leave? Yes No Later details gaps in historyNo( ) : PM d title (for most recent position held) Immediate supervisor an ( )______________ : or a medical condition, are there any days or times when you are________________________________ PM unavailable to work?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, 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 lawsHave 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? If no, please explain:________________________________ ____________________________________________________What did you like most about your position?If yes, give date(s) and position(s):____________________ This question is nvoitd de e is da ttoio enl iacbiot uint ftohrem eaxtiiostne nacbeo uotfaan d aispapbliicliatny,t \'sp adritsiacbulilairt y. Yes No Will you work overtime if required? . YesNonifgonremWhat were the things you liked least about the position? Have you submitted an application here before? ________________________________________________ Pleasmemsed at a la Telephone # EmployerTelephone # Includes disclosures protecting employer from liabilityEmployeradood naotito pnr ooter rw shteatghee rto a tchcoem emxtoednat tpioenrm isi tnteedce bsys alaryw. .These issues may be acdcdores If yes, give date(s) and position(s):If no, please explain:_________________________________Street address Yes No Need more information about the () StateStreet address() State_____________________ ____________________________________________________Have you ever been employed here before? .Yes Nojobs essential functions to respond CityCity ________________________________________________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 references Have you ever been employed here bYes No Are you able to perform the essential functions of the job for which From ____________ To ______________ al job titletoto efore? .you are applying (with or without reasonable accommodation)?Starting job title/fin / Immediate supervisor and title (for most recent position held)May we contact for reference?/ E-mail: /Is this application a request for reemployment following an extendedjob for which you are applying: / If yes, give dates: From ____________ 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?YesNo 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 Have you entered into an agreement with any former employer orSummarize the type of work performed and job responsibilities. to the extent permitted by law.in the United States? Summarize the type of work performed and job responsibilities. What 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 the Yes No other party (such as a noncompetition agreement) that might, in anyrom this company? .What did you like m ay, restrict your ability to work for our company? If yes, additional information may be requested. Drivers license numb jobs essential functions to respond/ / w ost about your position?YesNoDate available for work .______________What is your desired salary range or hourly rate of pay? 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 What were the things 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): StandardDL2-A2179$61.95.______________ Have you ever been b State ______________________________________________________________ What is your desired salar / / onded? .Yes NoWill you relocate if job requires it?Yes No ____________________________________________________ ComplyRight DownloadableDL2-A2179DL$42.95 $ y range or hourly rate of pay?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 PersonalizedDL2-A2179I$71.95 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)Explain any gaps in your employment, other than those due to personal illness, injury, or disability. _____________________________Street Address Starting with your most recent employer, provide the following information. 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 address City222 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/ 01792017protected 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? . YesNoE-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 Code () Summarize any special training, skills, languages, licenses, and/or certificates that may assist you in performing the position for which you are applying:E-mail address _________________________________________________________________ Phone () Street addressCityState ____________________________________________________________________________________________________________________________________Position applied for _____________________________________________________________Shift preferred123Any Excludes salary history questions in compliance with the salaryStarting job title/final job titleDates employedMonthYear 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? Yes No 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 # Educational BackgroundAre you lawfully authorized to work in the United States? Yes No ()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 FormStandardDL2-A0374 $49.95 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:______________________Degreecati Certifi on __________________ Yes No Need 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 DL2-A0374CFL$32.95 Why did you leave?Diplom GED Degree a______________________Certification __________________ _____________________________________________________________________________________________________________________________________ Personalized DL2-A0374I$59.95 Summarize the type of work performed and job responsibilities.Other________________________(Employer to list applicable exemptions)Diploma GED Starting with your most recent school attended, provide the following information. # of YearsCompleted GPA Major/Minor Long FormStandardDL2-A0019 $61.95 What did you like most about your position? Telephone #Diploma GEDComplyRight Job What were the things you liked least about the position?Certifi on __________________Educational Background Degreecati ______________________ Other________________________School (include City and State) Completed Class Rank EmployerDegreecati ______________________ Diplom GEDFill-and-Save DL2-A0019CFL$42.95 Street address() StateCertifi Applications complyon __________________Degree a______________________ City Other________________________cation __________________CertifiOther________________________ Personalized DL2-A0019I $71.95 Starting job title/final job titleDates employedMonthY ear MonthYear ReferencesDiplomGEDImmediate 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______________________ Certification __________________ List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors.Other________________________ E-mail:Diploma GEDPrice per pkg/50. Short form: 8" x 11". Long form: 17 x 11. Why did you leave? Yes No Later Name Title RelationshipTelephone E-mail # of Years Degreecati______________________ Personalize up to 4 lines.Summarize the type of work performed and job responsibilities. to You() Court decision onCertifi on __________________ KnownOther________________________ Diploma GEDDegreecati______________________ What did you like most about your position? () LGBTQ discrimination on __________________CertifiOther________________________Fill-and-Save item What were the things you liked least about the position? Page 2 Page 3 () in the workplace.Short Form; 2 pages18 WORKPLACE MANAGEMENTHIRING HRDIRECT.COM800.999.9111 19'