Application for Employment
Our policy is to provide equal employment opportunity to all qualified persons without regard to race,
creed, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status.
Last Name:_______________ First Name:_______________ Middle Initial:_____
City:_______________________________ State:________________ ZIP:________
Are you a U.S. citizen or otherwise authorized to work in the U.S.
on an unrestricted basis?
(You may be required to provide documentation)
Are you looking for full-time employment?__________
If no, what hours are you available?________________________________
Are you willing to work on weekends?_______________
Have you ever been convicted of a felony?__________
If yes, please describe conditions:_____________________________________________
Position applied for:__________________________________________________________________
How did you hear of this opening?:_________________________________________
Are you presently employed?:______________
May we contact your present employer?:____________
Are you available for full-time work?:____________
Are you available for part-time work?:____________
Will you relocate?:____________
Are you willing to travel?:___________ If yes, what percent?:_______________
Date you can start?:_____________________________________
Please feel free to fill out our employment application and E-mail it to us at firstname.lastname@example.org
1111 Howe Ave, Suite 535, Sacramento, CA 95825 Phone: (916) 488-4426 Fax: (916) 488-4796