Office Plus/ Office Furniture USA Employment Application

Date
Name
First
Last
Address
Street Address
City
State
Postal / Zip Code
Country
Phone
Alternate Phone
Email
Type of Work Desired
Office Machines / Equipment You Can Operate
Current Employment Status * EmployedUnemployedSelf-EmployedStudent
Can you provide proof that you are over 18 years of age? YesNo
If hired, can you provide proof that you have the right to work in the United States? YesNo
Salary / Wage Desired

MILITARY SERVICE RECORD

Branch of Service
Service Rank
Discharge Date
Present member of the National Guard? YesNo
Date obligation ends

CONVICTION RECORD

Have you ever been convicted of a violation of any local, state or federal law, other than minor traffic violation(s)? YesNo
Date of 1st Conviction
Violation Degree MisdemeanorFelony
Offense
Date of 2nd Conviction
Violation Degree MisdemeanorFelony
Offense

EDUCATION

High School: Years Attended*
High School Name*
High School City & State*
High School Graduate?*
College: Years Attended
College Name
College City & State
College Graduate? YesNo
Other/Trade School: Years Attended
Other/Trade School Name
Other/Trade School City & State
Other/Trade School Graduate? YesNo

EXPERIENCE (begin with the most recent experience)

#1: Date From
Date To
Name, Address, Phone #
Position Held
Reason for Separation
#2: Date From
Date To
Name, Address, Phone #
Position Held
Reason for Separation
#3: Date From
Date To
Name, Address, Phone #
Position Held
Reason for Separation

BUSINESS REFERENCES

#1: Name
Address
Phone
Occupation
#2: Name
Address
Phone
Occupation
#3: Name
Address
Phone
Occupation

PERSONAL REFERENCES

#1: Name
Address
Phone
#2: Name
Address
Phone
#3: Name
Address
Phone
PERSONAL GOALS
PLEASE READ BEFORE SUBMITTING: Drug screening and a full background check is a pre-requisite for employment.Incorrect information supplied by the prospective employee may be reason for immediate termination. Employer-employee relationship is at-will. Prospective employee releases both the past and prospective employers from litigation due to information retrieved through reference checks. AgreeDisagree
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