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 employedApplication 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 withoutu r Equal acc l ess t g o p i r 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 it a l il ie r a n b t l r e to a r ll p d er t s i a ons w e d it i h t o y u l t r l e Cit i l c y, Statea l ZIP l l o t l r o e r, disa c bilit r y, 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 informa r t t ion, gend r er, gende s r ident y, g a nder e t uc esion, mar xt al s t atus, me ec ic v l c t o h n irs tio s n, m gar t d t t o age, an r ce c st u r t y, c s, national oigin, f chil e (in t cu l des t s a f ts his t t e o r e ic ic ly as e s o t cia s ed w r l t t h race, s r io it h as ha x ir te b l r u s e and p le ot r an a m e ha r ba p e ic le r il e t ar e y or vete l d an s o at t u a e a gnany,o l cal l s Equal access to programs, services and employment opportunities is available to all persons without regard to sex (including pregnancy,In a dbir r h, breatee h ing, and/or r ated mdicl cond f ns), se p ual o e st ation, o oc y o aws, ap s), r o igion, sex (in r des p e, and/or lsexual orientation and gender identity), race, color, religion, national origin, citizens on? What did you like most about your position?What did you like most about your positi hip, age, disability, genetic information, or any otheror t ccodance w h te Am pr r e e t ans w r h Dis e a c bil ov e s Act and/or ap te ica dify ou ate and l art n l l i nt. E s x . uc is p t r e e l ed by fe e e r so t , s b o u ccommo r dationbasis 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,mak he appication and/or in at v io w process shoud no y the Human Re ces Dep e amp ans rquiring ra naIn accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonablesin ing a chane to the appic r n p in oc s; p iz iding w m t e e n n ma r m rias in an a s trnate for t mat s h a s of r il asonabe accmmdation e s incude accommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonableTelephone # EmployerTelephone # g a sign language in e; u g sp ia d equip t; o o ing teting cod ion s ba e, large pin, or adio rcoding; 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 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 #AddressLastDeborahName __________________________________________________________________A eld)licant ID # _____________________ May we contact for reference?E-mail: Yes No Later E-mail: StreetFirstMiddle A2451733 Main StreetHollywoodFL 33345LastFirstImmediate supervisor and title (for mMidost rdle ecent position h pp Yes No Later __________________________________________________________________________________________________Address __________________________________________________________________________________________________ Why did you leave? () City_____________________Why did you leave? Telephone # _________________Cellular/Other Phone # ________________ E-mail Address ____________________________954 554-1234() 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()Telephone # _________________ Summarize the type of work performed and job responsibilities ________________ Referral S Marketingon@ aol.comPosition(s) applied for _____________________________________________________ Date of application __________________Position(s) applied for _____________________________________________________ / / What did you like most about your position?What did you like most about your position?Date of application __________________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 employedMonthYear MonthY earPM cate if job requires it? . YesNoMay we contact you at work? .Starting job title/final job titleble to work?___________________________________ May we contact for reference?/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 ____________________________________________________ Yes No Later E-mail: Yes No Later 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 Why did you leave?NoImmediate supervisor and title (for most recent position held)________________________________ PM details gaps in history ( ) :PM or a medical condition, are there any days or times when you are______________________________________________ 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. can you furnish a work permit? N/AYes No ____________________________________________________Summarize the type o________________________________________________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?What were the things you liked least about th is on? it information about an appliicliatny,t \'sp adritsiacubillairt y.If yes Yes No Will you work overtime if required? . YesNoIf yes, give date(s) and position(s):____________________ T tioontipsr onvoitd ed e e positi da ttoio nel iacboodautti othne i se xniescteensscaer yo.fTah edsisea bissues may beEmployerTelephone #Phleisa sqeu deosn nifgonrme Have you submitted an application here before? ________________________________________________ acdcdormesmseodd aatti aon la oter rw shteatghee rt oa ctchoem emxtent permitted by law. Telephone # () Includes disclosures protecting employer from liability , give date(s) and position(s): _____________________ If no, please explain:_________________________________Employera ____________________________________________________()Have you ever been employed here before? .Yes NoYes No Need more information about the CityStateStreet addressCityState Street address jobs essential functions to respond________________________________________________If yes, give dates: From ____________ To ______________ Drivers licen se 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 / / / / al job title totoIs this application a request for reemployment following an extendedjob for which you are applying: May we contact for reference?/ E-mail: / Immediate supervisor and title (for most recent position held)May we contact for reference?E-mail: efore? .you are applying (with or without reasonable accommodation)?Starting job title/fin / /military leave of absence from this company? .Yes No ____________________________________State __________ Yes No Later Why did you leave? Yes No Later 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) If yes, additional information may be requested. Have you ever been bonded? . YesNo 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? to the extent permitted by law.Are you lawfully authorized to work Summarize th Have you entered into an agreement with any former employer orSummarize the type of work performed and job responsibilities. f following an extended military leave of absence Yes NoYesNoNeed more information about thein the United States? Yes No other party (such as a noncompetition agreement) that might, in anyWhat did you like most about your position? screen and interview candidates the right waye type of work performed and job responsibilities. rom this company? .What did you like most about your positi ur ability to work for our company?. .If yes, additional information may be requested. Drivers license numb jobs essential functions to respond/ / way, restrict yo on?YesNoDate 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): StandardLD1-A2179$69.95.______________ 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 DownloadableLD1-A2179DL$42.95 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 PersonalizedLD1-A2179I$80.95 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/ 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? 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 FormStandardLD1-A0374 $56.95 Immediate supervisor and title (for most recent position held)May we contact for reference?/to / Diploma GED particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law. E-mail: ______________________ Degreecation __________________Certifi YesNoNeed 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 LD1-A0374CFL$27.95 Why did you leave? Diploma GEDDegree ______________________Certification __________________ _____________________________________________________________________________________________________________________________________ Personalized LD1-A0374I$66.95 Summarize the type of work performed and job responsibilities. Other________________________(Employer to list applicable exemptions) GED What did you like most about your position?DiplomDegree a______________________Educational Background # of YearsCompleted GPA Major/Minor Long FormStandardLD1-A0019 $69.95 What were the things you liked least about the position? Telephone # State Diploma GEDComplyRight Job Starting with your most recent school attended, provide the following information. Certification __________________Other________________________School (include City and State) Completed GEDClass Rank Employer()Degreecati ______________________Diplom Fill-and-Save LD1-A0019CFL$32.95 Street addressCityCertifi Applications complyon __________________Degree a______________________ Other________________________Certification __________________ Other________________________ Personalized LD1-A0019I $80.95 Starting job title/final job titleDates employedMonthY ear MonthYear 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. SupremeDegree a______________________Diplom List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors.Certification __________________ Other________________________ E-mail: Diploma GED Why did you leave? Yes No Later NameTitleRelationshipTelephone E-mail # of Years ______________________ Price per pkg/50. Short form: 8" x 11". Long form: 17" x 11". to YouKnownCertifi on __________________ Personalize up to 4 lines.Summarize the type of work performed and job responsibilities. () Court decision onDegreecati Other________________________Diplom GED Degree a______________________ Other________________________ What did you like most about your position? () LGBTQ discriminationcation __________________CertifiFill-and-Save item What were the things you liked least about the position? Page 2 Page 3 () in the workplace.Short Form; 2 pages16 WORKPLACE MANAGEMENTHIRING HRDIRECT.COM800.999.9111 17'