Careers

QUAIL CORNER SHELL

APPLICATION FOR EMPLOYMENT

AN EQUAL OPPORTUNITY EMPLOYER
POSITION APPLIED FOR
REFERRED BY
DATE
NAME
PHONE(HOME)
PHONE(OTHER)
ADDRESS # 2
SOCIAL SECURITY NUMBER
ARE YOU A U.S. CITIZEN?or DO YOU HOLD A U.S. PERMANENT RESIDENT VISA (CIRCLE ONE)?
YES
NO
ARE YOU 18 YEARS OLD OR OLDER(CIRCLE ONE)?
YES
NO
IF UNDER 18, DATE OF BIRTH
HAVE YOU EVER BEEN CONVICTED OF A FELONY (CIRCLE ONE)?
YES
NO
IF YES, EXPLAIN
DO YOU HAVE ANY PHYSICAL HANDICAPS THAT WOULD PREVENT YOU FROM DOING CERTAIN TYPES OF WORK (CIRCLE ONE)?
YES
NO
IF YES, EXPLAIN

EMPLOYMENT RECORD(LIST MOST CURRENT JOB FIRST)

IF CURRENTLY EMPLOYED, MAY WE CONTACT YOUR PRESENT EMPLOYER (CIRCLE ONE)?
YES
NO
NAME OF COMPANY
ADDRESS
CITY, STATE & ZIP
TELEPHONE
SUPERVISOR
NAME OF COMPANY
ADDRESS
CITY, STATE & ZIP
TELEPHONE
SUPERVISOR
NAME OF COMPANY
ADDRESS
CITY, STATE & ZIP
TELEPHONE
SUPERVISOR
DATES OF EMPLOYMENT(FROM)
(TO)
POSITION
STARTING SALARY
ENDING SALARY
REASON FOR LEAVING
DATES OF EMPLOYMENT(FROM)
(TO)
POSITION
STARTING SALARY
ENDING SALARY
REASON FOR LEAVING
DATES OF EMPLOYMENT(FROM)
(TO)
POSITION
STARTING SALARY
ENDING SALARY
REASON FOR LEAVING

EDUCATION

NAME AND LOCATION OF SCHOOL
GRADE SCHOOL
MIDDLE SCHOOL
HIGH SCHOOL
COLLEGE/UNIVERSITY
CIRCLE LAST GRADE FINISHED
1
2
3
4
5
6
6
7
8
9
9
10
11
12
1
2
3
4
5
6
GRADUATE
YES
NO
YES
NO
YES
NO
YES
NO
MAJOR/DEGREE
GPA
OTHER
SPECIALIZED TRAINING
HONORS RECEIVED

MILITARY SERVICE

GRADE SCHOOL
RANK(START)
(END)
DUTIES
SPECIAL SKILLED REQUIRED
REASON FOR CHANGE IN RANK

REFERENCE

GIVE BELOW THE NAMES OF FOUR PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN FOR AT LEAST TWO YEARS. INCLUDE A COMBINATION OF FORMER SUPERVISORS, PEERS, SUBORDINATES AND PERSONAL CONTACTS.
NAME
ADDRESS
CITY, STATE & ZIP
TELEPHONE
NAME
ADDRESS
CITY, STATE & ZIP
TELEPHONE
NAME
ADDRESS
CITY, STATE & ZIP
TELEPHONE
NAME
ADDRESS
CITY, STATE & ZIP
TELEPHONE
ARE THERE ANY TIMES OF DAY OR DAYS OF THE WEEK THAT YOU WOULD BE UNAVAILABLE (CIRCLE ONE)?
YES
NO
IF YES, EXPLAIN
IS THERE ANYTHING ELSE YOU WOULD LIKE TO INCLUDE AS ADDITIONAL INFORMATION?
REFERENCE
I CERTIFY THAT THE ANSWERS GIVEN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I HEREBY GIVE QUAIL CORNERS SHELL PERMISSION TO VERIFY THIS INFORMATION AND RELEASE ALL PERSONS AND QUAIL CORNERS SHELL WITH RESPECT TO ANY SUCH INFORMATION PROVIDED BY MY PRIOR EMPLOYERS OR PERSONAL REFERENCES. I ACKNOWLEDGE THAT IF ANY INFORMATION IN THIS APPLICATION IS UNTRUE. I MAY BE TERMINATED. I UNDERSTAND THAT IF I AM EMPLOYED, MY CONTINUED EMPLOYMENT IS AT ALL TIMES SUBJECT TO THE POLICIES AND PROCEDURES ESTABLISHED BY MLDB, INC. FROM TIME TO TIME AND THAT MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME BY ME OR QUAIL CORNERS SHELL WITH OR WITHOUT CAUSE.
APPLICANT SIGHNATURE
DATE