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-Compliant 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 withoutr Eq il ual acc l ess t t o p i r f i ogr d ams, se t r a v l r ic i e e s an l d e e t mp it e loy i l i m e i e e l nt op t p i x i o p r i r tun s i t ties is av l i l t i a f l il ie r a n b t l r e t e o a l r l r l p d e t r t s i a ons w i e d it i s h . t o y u l Cit l l r y,i l Statel e l ZIP l l t y, c a l o t l r o e r, disa c bil r i c t r l 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 applicationsc g a e c netic infor r ma r t t ion, gend r er, gende s r id e ent y, g a nder e t f uc 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, national o o igin, h e (in t cudes t s ats histo e ic ic ly as e i o t ciaed wt t h race, s io h as ha x ir te b r ue and pot r an e ha r ba n, mil e t ary or vete d an s des p gnany, Equal access to programs, services and employment opportunities is available to all persons without regard to sex (including pregnancy,In a dbir r h, bea t ee h in t g, an e d/or r s at c d m c d r ic v l con q d rt n e s), se t ual o e st ation, o p oc t a y o aws, app es), r o r ig e ion, sex (in r r so t , s b o e, and/or l d cal l s sexual orientation and gender identity), race, color, religion, national origin, citizenship, age, disability, genetic information, or any otherWhat did you like most about your position?What did you like most about your position? or t ccodan l ce w h te A e m pr r e t ans w r h Dis e abil ou e s Act and/or app e ica sou ate and l ar l l nt. Ex uc is p t ec e ed by f e e cc na e accommodatio 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 s k he appica g ion and/or in licat v io w process sh o d no y the Human Re ces De me icans rquiring raIn accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonablemaing a chane to the ap r p er n p in o ss; p iz iding w m te n n ma r m rias in an a s tenae for t mat s ampes of r il asonabe a in ommdation e s in udaccommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonableTelephone # EmployerTelephone # uing a sign language in ; u g sp ia d euip ; o od ying t ting cond ion h as ba e, large p , or audio rco ing; Employer 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 language large print or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions. CityCity Street address Immediate supervisor and title (for most recent position held)May we contact for reference?/to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / Sim onStarting job title/final job titleDates employedMonthY ear MonthYear Starting job title/final job titleDates employedMonthY ear MonthYear and proper legal disclosures.Name __________________________________________________________________ Applicant ID # AddressLastDeborahStreetFirstMiddle A2451733 Main StreetHollywoodFL 33345Name __________________________________________________________________ Applicant ID #_____________________ Yes No Later E-mail: Yes No Later E-mail: __________________________________________________________________________________________________LastFirstMiddleAddress __________________________________________________________________________________________________ Why did you leave? () City_____________________Why did you leave? Telephone # _________________Cellular/Other Phone # ________________ E-mail Address ____________________________954 554-1234Telephone # _________________Cellular/Other Phone # ________________ E-mail Addres . s ____________________________ 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 S 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 ource(e.g., Walk-in, Job Posting, Companys Website, etc.) 3 14 2017What were the things you liked least about the position? / /If necessary, b_________________________________________________________EmployerAMTelephone # EmployerTelephone #: PMest time to call you is ______________ : Will you reloIf necessary, best time to call you is ______________ Will you travel if job requires it? Yes No () StateStreet address() StateAsks probing job-related questions including skills, May we contact you at work? .Yes No attendance requirements of the position? . N/A Yes No Dates employedMonthYear MonthYear Starting job title/final job titleDates employedMonthYear MonthYearPM cate if job requires it? . YesNo HomeCellular/Other Street addressIf they have been explained to you, are you able to meet the CityCity HomeCellular/Other 2 00AMIf yes, work number and best time to call: Starting job title/final job title ork overtime if required? . YesNo /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? Will you w If yes, work number and best time to call:Yes AM Other than time off for reasons related to your religion, a disability,________________________________:AM d title (for most recent position held)May we contact for reference?E-mail: Yes No LaterYes NoImmediate supervisor an If no, please explain:_______________________________ E-mail:( ) ______________ Yes No LaterIf you are under 18 and it is required, PM________________________________________________ Why did you leave? details gaps in history ( ) :PM or a medical condition, are there any days or times when you are______________________________________________ unavailable to work?Why did you leave? N/A Yes No Are you able to perform the essential functions of the job for which. Summarize the type of work performed and job responsibilities. If you are under 18 and it is required, can you furnish a work permit? Summarize the type of work performed and job responsibilitiesithout reasonable accommodation)?can you furnish a work permit? N/AYes No ____________________________________________________you are applying (with or wIf no, please explain:_______________________________ e most about your position? in out an apapbliilciatny,t \'ps adritsiacublilairt y.What did you like most about your position? Complies with all federal and state laws Have you submitted an application here before? Yes No This question is not designremda ttoio enl iacbito uintf tohrem eaxtiisotne nabcaer oy.fTah deisse issues may beWhat were the things you liked least about the position? If no, please explain:________________________________ ____________________________________________________What did you likPlease dood naotito pnr oovr rw s ethfoe tro a tchcoem emxtoednat tpioenrm isi tnteedce bsys law.ad d at a late idehtagea ccdormesmse ed least about the position? Yes No Will you work overtime if required? . YesNoWhat were the things you lik Have you submitted an application here before? If yes, give date(s) and position(s):____________________ ________________________________________________Yes No Need more information about the Telephone # EmployerTelephone # Includes disclosures protecting employer from liability If yes, give date(s) and position(s):If no, please explain:_________________________________Employer jobs essential functions to respond () Street address() State_____________________ ____________________________________________________Have you ever been employed here before? .Yes No Drivers license number required if driving may be required in theCityStateCity Street address ________________________________________________If yes, give dates: From ____________ To ______________ job for which you are applying: State __________ Dates employedMonthY ear MonthYear Starting job title/final job titleDates employedMonthYear 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 / / / /Starting job title/final job title to /to / efore? .you are applying (with or without reasonable accommodation)?Is this application a request for reemployment following an extended____________________________________/ / Immediate supervisor and title (for most recent position held)May we contact for reference?E-mail: If yes, give dates: From ____________ To/ / This question is not designed to elicit information about an applicant\'s disability. Please military leave of absence from this company? .Yes No Have you ever been bonded? . YesNo May we contact for reference?E-mail: Yes No LaterImmediate supervisor and title (for most recent position held) If yes, additional information may be requested. Have you entered into an agreement with any former employer orYes No Later Why did you leave? Includes a ComplyRight guide to help you / / ______________ do not provide information about the existence of a disability, particular accommodation, Is this application a request for reemployment or whether accommodation is necessary. These issues may be addressed at a later stage Why did you leave?other party (such as a noncompetition agreement) that might, in anySummarize the type of work performed and job responsibilities. to the extent permitted by law.Are you lawfully authorized to workSummarize the type of work performed and job responsibilities.YesNo f following an extended military leave of absence Yes NoYesNoNeed more information about thein the United States? Yes No way, restrict your ability to work for our company?. .What did you like most about your position? screen and interview candidates the right way rom this company? .If yes, please explain: _______________________________What did you like most about your position? If yes, additional information may be requested. Drivers license numb jobs essential functions to respondDate available for work . / /________________________________________________ What were the things you liked least about the position?______________What is your desired salary range or hourly rate of pay? What were the thin gs you liked least about the position? Are you lawfully authorized to work in er required if driving may be required in the________________________________________________$ _______________________Per _________________ NOTE TO RHODE ISLAND APPLICANTS: This company is subject to the states workers compensationPage 2 DescriptionItem #Price the United States? Yes No job for which you are applying:laws (Chapter 29-38) unless otherwise noted below (employer to list applicable exemptions): Page 2 Date available for work ____________________________________Type of employment desired: Full-Time Part-Time ____________________________________________________ Educational Co-Op Seasonal Temporary ____________________________________________________ StandardDL1-A2179$61.49.______________ Have you ever been b State __________What is your desired salar / / onded? .Yes NoWill you relocate if job requires it?Yes No ____________________________________________________ $ y range or hourly rate of pay?AN EQUAL OPPORTUNITY EMPLOYER Page 1 ComplyRight DownloadableDL1-A2179DL$61.49 Typ_______________________ Per _________________ Have you entered into an agreement with any former employer or 50-State Compliant Job Application PersonalizedDL1-A2179I$71.49 Downloadable e of employment desired: Full-Time Part-Time other party (such as a noncompetition agreement) that might, in anyEducational 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 Street addr ABC, Inc. 954555-1212 State____________________________________________________________________________________________________________()ess 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?________________________________________________________________________________________________________Last First MiddleAddress _____________________________________________________________________________________________________ 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:Email address _________________________________________________________________ Phone () Street addressCityState ____________________________________________________________________________________________________________________________________Position applied for _____________________________________________________________Shift preferred12 3 Any 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 #Are you lawfully authorized to work in the United States? Yes No DescriptionItem #Price () Educational BackgroundStreet addressCityStateStarting with your most recent school attended, provide the following information.If you are under 18 years old, can you furnish a work permit if required?N/AYesNo Starting job title/final job titleDates employedMonthYear MonthYear # of YearsCompleted GPA Major/MinorAre you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation)?disability,Short FormStandardDL1-A0374 $49.49to School (include City and State) CompletedDiploma GED Class RankThis question is not designed to elicit information about an applicants disability. Please do not provide information about the existence of a/ / ______________________ particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law. Immediate supervisor and title (for most recent position held)May we contact for reference?E-mail:on __________________ CertifiDegreecatiYes No Need more information about the jobs essential functions to respond.Downloadable DL1-A0374DL$32.99 Why did you leave? 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: Diploma GED _____________________________________________________________________________________________________________________________________ Personalized DL1-A0374I$59.49 Summarize the type of work performed and job responsibilities. Degree ______________________Certification __________________Other________________________(Employer to list applicable exemptions)Diploma GEDEducational Background Long FormStandardDL1-A0019 $61.49 What were the things you liked least about the position? CertifiGEDComplyRight Job What did you like most about your position? ______________________ Degreecation __________________Starting with your most recent school attended, provide the following information.Other________________________School (include City and State) # of YearsCompleted GPA Major/Minor EmployerTelephone # Diplom Degree a______________________CompletedDiploma GEDClass Rank Downloadable DL1-A0019DL$32.99 ()Degreecati ______________________ Street addressCityStateApplications complyCertification __________________ Other________________________Certifi a on __________________ Personalized DL1-A0019I $71.49 Starting job title/final job titleDates employedMonthYear MonthYear ReferencesOther________________________DiplomGEDImmediate 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 June 2020 U.S. Degree ______________________ 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________________________ Price per pkg/50. Short form: 8" x 11". Long form: 17 x 11. Why did you leave? Yes No Later NameTitleRelationshipTelephoneE-mailDiplomaGEDPersonalize up to 4 lines.Summarize the type of work performed and job responsibilities. to You() Supreme Court decision __________________ of Ywnears Degreecation ______________________ # KnoCertifiOther________________________GEDDiplomDegree a______________________ Certification __________________ What did you like most about your position? () on LGBTQ discriminationOther________________________Downloadable 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'