b'Legally Gather RelevantInformation from Job CandidatesEmployment History Employment History ComplyRightCaliforniaStarting 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. State-Compliant Application Application for Employment Your Company NameEmployerTelephone # EmployerTelephone #() () Please Print Street AddressStreet addressYour Company Name CityMonthY Stateear Street addressCityMonthY Stateear for Employment City, State ZIPApplication for Employment Street Address Dates employedear MonthY Starting job title/final job titleDates employedear MonthYPlease Print Starting job title/final job titleCity, State ZIP May we contact for reference?/to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / Equal acc l e f s o s t g 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 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 egar it l d t t o age, an r ce c s a l t u l r t y, c a l o t l r o e r, disa c bilit r y, aw.r g a e c netic in d r r ma r t t ion, gend r er, gende s r id i e e c nt s a y, g t a nder e t f uc esion, mar xt al s t atus, me e o c ic a v l c t o h n irs tio s n, m r il e t ary or vete d an sat t us, national o o igin, Immediate supervisor and title (for most recent position held)E-mail: E-mail:Why did you leave? Yes No Later Why did you leave? Yes No Later Gather the job-related information you need withoutil e (incu l es t s ats histo e ic ic ly as e o t cia e ed wth race, s io h as ha x ir te b r ue and pot r an e ha r ba es), r o igion, sex (in r des p gnany, f ch dbirth, be t a io t a ee h in t g, an e d/or r s at o d m c b d il ic liz u l cond rit n e s), se p ual o l if e st atio s l n, o par c t y o i aws, app is p l t r ec e l ed by fe l e e r so t , s b o e, and/or l cl cal l s In accordance w u h t h e A e m p r r e a ans w r h Dis e s sho v e s Act and/or ap te ica sou ate and l t l l nt. Ex uc icans r e quiring ra cc na e accommodationEqual access to programs, services and employm Summarize the type of work performed and job responsibilities r . sons without regard to sex (including pregnancy),Summarize the type of work performed and job responsibilities. crossing into illegal territory. These specific applicationsBESTSELLERent opportunities is available to all pe u or the appica e t n and/or in ict v io w pr css; pro d no uip y the Human Re yin ces De na o me r t mat s ampes of r il asonabe a in ommdation e s in d ude race, color, religion, national origin, citizenship, age, disability, genetic information, or any other basis protected by federal, state, making a chan g o te ap rp ter n p in o ia iding w m te n n ma r m rias in an ater g c e fo ions. h as ba e, large p , or audio rcoring; and/or local law.What did you like most about your position? What did you like most about your position? sing a sign lan ge in ; u g sp d eq t; o od g tetin ndIn accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonableWhat were the things you liked least about the position? are available for every state and the District of Columbia, What were the things you liked least about the position?accommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonable accommodations include making a change to the application process; providing written materials in an alternate format such as braille,EmployerTelephone #EmployerTelephone # StateStreet address() Stateand are carefully worded to include the correct language Sim onlarge print or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions. () Name __________________________________________________________________ Applicant ID # AddressLastDeborahStreet addressCityCity Starting job title/final job titleDates employedMonthY ear MonthYear Starting job title/final job titleDates employedMonthY ear MonthYear and proper legal disclosures.StreetFirstA2451733 Main StreetHollywoodFL 33345Name __________________________________________________________________ Applicant ID #_____________________ /to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / __________________________________________________________________________________________________() Middle _____________________Telephone # _________________Cellular/Other Phone # ________________ CityStateZIP CodeLastImmediate supervisor and title (for most recent position held)May we contact for reference?E-mail: E-mail: 954 554-1234FirstMiddle Sim on@ aol.comStreetWhy did you leave? CityStateZIP Code Yes ()Address __________________________________________________________________________________________________ No Later Why did you leave? Yes No Later Position(s) applied for _____________________________________________________ Date of application __________________Referral S Marketing E-mail Address ____________________________() Cellular/Other ()E-mail Address ____________________________ Summarize the type of work performed and job responsibilities. Asks probing job-related questions including skills, Telephone # _________________Phone # ________________ ource(e.g., Walk-in, Job Posting, Companys Website, etc.) 3 14 2017Summarize the type of work performed and job responsibilities. / /Position(s) applied for _____________________________________________________ Date of application __________________ What did you like most about your position? / /Referral SourceWhat did you like most about your position? What were the things you liked least about the position? employment history and reasons for leaving, and If necessary, b_________________________________________________________(e.g., Walk-in, Job Posting, Companys Website, etc.)_________________________________________________________What were the things you liked least about the position?est time to call you is : AMIf necessary, best time to call you is ______________ Will you travel if job requires it? YesNo EmployerTelephone # also details gaps in historyHomeCellular/Other ______________ Will you relo2 00PMEmployer:AM PM Telephone # HomeCellular/Other Street addressIf they have been explained to you, are you able to meet the() StateStreet addressCityStateYes No cate if job requires it? . Yes () May we contact you at work? .NoMay we contact you at work? .Yes No attendance requirements of the position? . N/AYesNo If yes, work number and best time to call: Will you travel if job requires it? Yes NoCityIf yes, work number and best time to call: Starting job title/final job titleWill you work overtime if required? . YesNo MonthYear MonthYear Starting job title/final job titleDates employedMonthYear MonthYear Complies with all federal and state lawsAM If no, please explain:Dates employed to / Immediate supervisor and title (for most recent position held)May we contact for reference?/to / ( ) If they have b ________________________________:or most recent position held) _______________________________ / E-mail: E-mail:________________________________: AM een explained to you, are you able to meet the ( ) ______________ May we contact for reference?If you are under 18 and it is required,______________ attendance requirements of the position? .N/A Yes NoImmediate supervisor and title (f PM________________________________________________No Later Yes No Later PMIf you are under 18 and it is required,N/A Yes NoYes Why did you leave? Includes disclosures protecting employer from liability can you furnish a work permit? No Will you work overYesNoWhy did you leave? Are you able to perform the essential functions of the job for which can you furnish a work permit? you are applying (with or without reasonable accommodation)?. Summarize the type of work performed and job responsibilities. If no, please explain:N/AYes time if required? .If no, please explain:_______________________________ T ed and job responsibilities esigned to elicit information about an applicant\'s disability.________________________________ If no, please explain:Summarize the type of work perform his question is not d ________________________________ Have you submitted an application here before? Yes No Please do not pr oovri wdeh einthfoerrm aacctoiomnm aobdouatti othne i se xniestceensscaer oy.fTah edsisea ibsisliuteys,pmaaryti cbuel arWhat did you like most about your position? Authorizes employment references Have you submitted an application here before? Yes Noa msmseodd aatti oan later stage to the extent permitted by law. If yes, give date(s) and position(s): ________________________________________________acdcdoreWhat did you like most about your position?If yes, give date(s) and position(s):____________________ on? No Need more information about the What were the things you liked least about the position? _____________________ Are you able to perform the essential functions of the job for whichYesWhat were the things you liked least about the positi ________________________________________________jobs essential functions to respond EmployerTelephone # Includes a ComplyRight guide to help you________________________________________________ you are applying (with or without reasonable accommodation)?EmployerTelephone #Have you ever been employed here before? .Yes No Drivers license number required if driving may be required in t() heStreet address() StateHave you ever been employed here before? .Yes No This question is not designed to elicit information about an applicant\'s disability. Please / / ______________ If yes, give dates: From/ / do not provide information about the existence of a disability, particular accommodation, eet addressCity If yes, give dates: From ____________ ToStr / / job for which you are applying: CityState Starting job title/final job title____________________________________State __________ MonthYear MonthYear Starting job title/final job titleDates employedMonthY ear MonthYear screen and interview candidates the right way ____________ To/ / or whether accommodation is necessary. These issues may be addressed at a later stage Is this application a request for reemployment following an extendedDates employed to /to / to the extent permitted by law.military leave of absence from this company? .Yes No Have you ever been bonded? . YesNo / E-mail: / Immediate supervisor and title (for most recent position held)May we contact for reference?E-mail: Is this application a request for reemployment YesNo______________If yes, additional information may be requested. Have you entered into an agreement with any former employer orNo Later Why did you leave? Yes No Later f following an extended military leave of absence Need more information about theImmediate supervisor and title (for most recent position held)May we contact for reference?YesAre you lawfully authorized to work Why did you leave? other party (such as a noncompetition agreement) that might, in anyDescriptionItem #Price rom this company? .Yes NoDrivers license numb jobs essential functions to respondin the United States? Yes No way, restrict your ability to work for our company? YesNo Summarize the type of work performed and job responsibilities. If yes, additional information may be requested. er required if driving may be required in the Date available for work .______________ If yes, please explain: _______________________________ What did you like most about your position? StandardPB1-A2179$61.49 Are you lawfully authorized to work in job for which you are applying:Summarize the type of work performed and job responsibilities./ /What did you like most about your position?________________________________________________ the United States? Yes No ____________________________________State __________What is your desired salary range or hourly rate of pay?________________________________________________ What were the things you liked least about the position?$ _______________________Per _________________ NOTE TO RHODE ISLAND APPLICANTS: This company is subject to the states workers compensationPersonalizedPB1-A2179I$71.49What were the things you liked least about the position? Date available for work / / Have you ever been bonded? .Yes Nolaws (Chapter 29-38) unless otherwise noted below (employer to list applicable exemptions): Page 2. ______________Type of employment desired: Full-Time Part-Time ____________________________________________________ Page 2 What is your desired salary range or hourly rate of pay? Educational Co-Op Seasonal Temporary ____________________________________________________ Price per pkg/50. Size: 17" x 11". $ _______________________ PerHave you entered into an agreement with any former employer or Will you relocate if job requires it?Yes No ____________________________________________________ Personalize up to 4 lines. Go to page 81 Type of employment desired: _________________ other party (such as a noncompetition agreement) that might, in any AN EQUAL OPPORTUNITY EMPLOYER Page 1 for personalization information. Educational Co-Op Full-Time Part-Time way, restrict your ability to work for our company? Yes No Seasonal Temporary If yes, please explain:_______________________________ ________________________________________________Long Form; 4 pagesAN EQUAL OPPORTUNITY EMPLOYEREmployment History Employment History(continued)Page 1Starting 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. _____________________________EmployerTelephone #ABC, Inc.954555-1212 ____________________________________________________________________________________________________________ComplyRight Street address() State____________________________________________________________________________________________________________City222 Stirling WayHollywoodFL33345Your Company Name 50-State Compliant Job Application Starting job title/final job title 3/to /2017 ____________________________________________________________________________________________________________Dates employedMonthYear MonthYearStreet Address MarketingMay we contact for reference? 20179 If not addressed on previous page, have you ever been fired or asked to resign from a job? .YesNoImmediate supervisor and title (for most recent position held)E-mail:Application for Employment City, State ZIP Ms. Taylor Yes No Later If yes, please explain:_______________________________________________________________________________________Why did you leave?Please Print If you have businesses in more than one state, theseLocation reasons________________________________________________________________________________________________________Equal access to programs, services and employment opportunities is available to all persons without regard to sex (including pregnancy), race,Summarize the type of work performed and job responsibilities.color, religion, national origin, citizenship, age, disability, genetic information, or any other basis protected by federal, state, and/or local law. applications are the best to get the job-related informationWhat did you like most about your position?________________________________________________________________________________________________________In accordance with the Americans with Disabilities Act and/or applicable state and local laws, applicants requiring reasonable ________________________________________________________________________________________________________accommodations for the application and/or interview process should notify the Human Resources Department. Examples of reasonableWhat were the things you liked least about the position?accommodations include making a change to the application process; providing written materials in an alternate format such as braille,you need. Theyre attorney developed and carefullyEmployerTelephone # Skills and Qualificationslarge print, or audio recording; using a sign language interpreter; using specialized equipment; or modifying testing conditions. () Summarize any special training, skills, languages, licenses, and/or certificates that may assist you in performing the position for which you are applying:worded to include the correct language and proper Street addressCityState____________________________________________________________________________________________________________Name _______________________________________________________________________________________________________ Starting job title/final job titleDates employedMonthYear MonthYear ____________________________________________________________________________________________________________LastFirstStateMiddle ZIP Code legal disclosures required by all federal and state laws. Immediate supervisor and title (for most recent position held)May we contact for reference?/to / ____________________________________________________________________________________________________________Address _____________________________________________________________________________________________________ E-mail:StreetCity Email address _________________________________________________________________ Phone () Why did you leave? Yes No Later Computer Skills(Include software titles and level of experience, such as basic, intermediate, or advanced.)________________________Position applied for _ ____________________________________________________________Shift preferred123Any Summarize the type of work performed and job responsibilities.Word Processing _________________________Level: _____ Internet ________________________________Level: ______ Contains mandatory disclosures for all 50 statesSpreadsheet _____________________________Level: _____ Other __________________________________Level: ______ Special training or skills (languages, machine operation, etc.) that would benefit you in the job for which you are applying: What did you like most about your position?Presentation____________________________Level: _____ Other __________________________________Level: ______ ___________________________________________________________________________________________________________________________ Excludes criminal questions in compliance What were the things you liked least about the position?E-mail _________________________________Level: _____ Other __________________________________Level: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ with ban the box laws EmployerTelephone # Educational Background()Would you accept full-time work? Yes NoWould you accept part-time work? Yes No Street addressCityStateStarting with your most recent school attended, provide the following information.School (include City and State) # of YearsCompleted GPA Major/MinorOn what date would you be available for work? ________________________________ Excludes salary history questions in compliance Starting job title/final job titleDates employedMonthY ear MonthYear CompletedGEDClass RankImmediate supervisor and title (for most recent position held)May we contact for reference?/to /Diploma______________________ Have you ever been employed here? Yes NoIf yes, dates:_________________________________________________________ E-mail:Degree Are you lawfully authorized to work in the United States? Yes No with the salary history ban and equal pay laws Why did you leave? Yes No Later Certification __________________ Other________________________If you are under 18 years old, can you furnish a work permit if required? N/A Yes NoDegree a______________________Diplom GED Are you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation)?Summarize the type of work performed and job responsibilities.Certification __________________ This question is not designed to elicit information about an applicants disability. Please do not provide information about the existence of a disability,Includes a ComplyRight guide to help you screen What did you like most about your position?Other________________________particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.Diploma GEDDegree ______________________ Yes No Need more information about the jobs essential functions to respond.and interview candidates the right way What were the things you liked least about the position? Certification __________________Other________________________Notice to Rhode Island applicants: This Company is subject to the states workers compensation laws (Chapters 29-38) unless otherwise noted below:Diploma GED _____________________________________________________________________________________________________________________________________Degreecati______________________EmployerTelephone # on __________________(Employer to list applicable exemptions) () CertifiOther________________________Educational Background Street addressCityState Starting with your most recent school attended, provide the following information. DescriptionItem #Price Starting job title/final job titleDates employedMonthYear MonthYear ReferencesSchool (include City and State) # of YearsCompleted GPA Major/Minor /to / List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. Completed Diploma GEDClass Rank Immediate supervisor and title (for most recent position held)May we contact for reference?E-mail: If not applicable, list three school or personal references who are not related to you. ______________________ Short FormStandardPB1-A0374 $49.49 Why did you leave? Yes No Later Title RelationshipTelephoneE-mail# Kno Degreecation __________________ Nameto Youof YwnearsCertifiOther________________________a______________________Personalized PB1-A0374I$59.49 Summarize the type of work performed and job responsibilities. ()Diplom GED Degreecation __________________Certifi Other________________________What did you like most about your position?Degreea GEDLong FormStandardPB1-A0019 $61.49 What were the things you liked least about the position? ()Diplom ______________________ () Expand Your Certification __________________Other________________________ Diploma GEDPersonalized PB1-A0019I $71.49 Page 2 Page 3Certifi ______________________ Price per pkg/50. Short form: 8" x 11". Long form: 17 x 11.Recruitment Reach Degreecation __________________ Other________________________Personalize up to 4 lines. Go to page 81 forShort Form; 2 pages personalization information.Page 1618 HIRING TOOLS HRDIRECT.COM800.999.9111 19'