Name: (Last, First, Middle)
 Date: (DY/MO/YR)
Address:
 Phone: (Include Area Code)
City:
 State:
 Zip Code:

Personal Data
State Age if under 18 years of age:

Classification
of position
applying for:

Full Time
Part Time
Temporary

Shift Preference:
1st shift (7am-3pm)
2nd shift (3pm-11pm)
3rd shift (11pm-7am)

Day Preference:
SU
MO
TU
WE
TH
FR
SA
 
Do you have the legal right to work in the USA?
Yes: , No:

Have you ever been convicted of any crime other than a minor traffic violation?
Yes: , No:

If yes, when, where and disposition:

Conviction will not necessarily disqualify an applicant, but will only be considered with respect to the specific requirements of the job for which they are applying.
SCOTT ENTERPRISE History

Have you ever been employed by SCOTT ENTERPRISE?
Yes: , No:

If yes, where/position/when:

Do you have any relatives employed at SCOTT ENTERPRISES or any related company?
Yes: , No:

If yes, give names and locations:

JOB INTEREST
Position Applied For:
Date Available for Work:
Starting Wage Expected:


EMPLOYMENT HISTORY

Company 1
Company Name, Address & Phone

Employment Dates: from (MO/YR) , to (MO/YR)

Your position & duties:

Your Supervisor:

Base Wages/Salary: Starting: , Final:

Explain your reason for leaving:
Company 2
Company Name, Address & Phone

Employment Dates: from (MO/YR) , to (MO/YR)

Your position & duties:

Your Supervisor:

Base Wages/Salary: Starting: , Final:

Explain your reason for leaving:
Company 3
Company Name, Address & Phone

Employment Dates: from (MO/YR) , to (MO/YR)

Your position & duties:

Your Supervisor:

Base Wages/Salary: Starting: , Final:

Explain your reason for leaving:
Company 4
Company Name, Address & Phone

Employment Dates: from (MO/YR) , to (MO/YR)

Your position & duties:

Your Supervisor:

Base Wages/Salary: Starting: , Final:

Explain your reason for leaving:

 

Educational History
Choose the last year of education completed:
1-12 , College: , Graduate School:
Main Course of Study:

 Degree(s):
 School:
Relevant Courses you are taking now:
 Relevant Courses you expect to take:
Relevant Special Courses, Licenses or Training:

 

References 1
Name:
 Title:
 Phone:
Relationship:
 Address:
References 2
Name:
 Title:
 Phone:
Relationship:
 Address:

APPLICANT: Please Read The Statement Below Carefully Before Signing

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from liability for any damage that may result from furnishing same to you. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause."

Type Your Full Name (First, Middle, Last)