Applicant Information

Full Name (required)

Date of Application

Address

City, State, ZIP

Phone Number

Email Address

Position Applied For

Are you legally authorized to work in the U.S.?

YesNo

Do you have a valid driver's license?

YesNo

Have you ever been convicted of a felony? (Convictions do not
automatically disqualify applicants.)

YesNo

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How Did You Hear About This Job?

ReferralCompany WebsiteSocial MediaWalk-InOther

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Employment History

Employer #1

Company Name

Phone Number

Address

Job Title

Supervisor's Name

Start Date

End Date

Reason for Leaving

Responsibilities

Employer #2

Company Name

Phone Number

Address

Job Title

Supervisor's Name

Start Date

End Date

Reason for Leaving

Responsibilities

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Education

High School

Did you graduate?

YesNo

College / Trade School

Degree or Certification

Did you graduate?

YesNo

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Why Are You Applying & Skills

(Briefly explain why you are interested in working at The Water Shop, Inc.)

Skills & Qualifications

(List any relevant skills, certifications, or qualifications.)

You may attach a resume if you would like to provide additional
details about your work experience and qualifications.

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References

(List three professional references, no family members.)

Reference #1

Full Name

Relationship

Phone Number

Reference #2

Full Name

Relationship

Phone Number

Reference #3

Full Name

Relationship

Phone Number

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Acknowledgment & Signature

I certify that my answers are true and complete to the best of
my knowledge. I understand that any false or misleading information
in my application may result in my disqualification or termination.

I certify that the above is true and accurate.

Typed Signature (Full Name)

Date

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