Sample Employment Application Form

PLEASE PRINT ALL

INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS

PLEASE COMPLETE PAGES 1-4.

DATE ________________________________

Espiritu
Marissa
Isabel
Name ______________________________________________________________________________________________
Last

First

Middle

Maiden

4364 Heyer Ave. Castro Valley, CA 94546

Present address ______________________________________________________________________________________
Number

Street

3 years
How long ____________________
510) 423-1888
Telephone (

City

State

Zip

Social Security No. _______ _____ _________

17
If under 18, please list age _____________________
Days/hours available to work
No Pref _______ Thur ________
Mon __________ Fri __________
Tue __________ Sat _________
Wed _________ Sun ________

Position applied for (1) ________________________

and salary desired (2) ________________________
(Be specific)

How many hours can you work weekly? _________________________ Can you work nights? _______________________
Employment desired

X PART-TIME ONLY
__

__ FULL-TIME ONLY

__ FULL- OR PART-TIME

When available for work?_______________

____________________________________________________________________________________________________

TYPE OF SCHOOL

High School

NAME OF SCHOOL

Castro Valley High

LOCATION
(Complete mailing
address)

19400 Santa Maria Ave

Castro Valley, CA

NUMBER OF YEARS
COMPLETED

MAJOR &
DEGREE

College
Bus. or Trade School
Professional School

HAVE YOU EVER BEEN CONVICTED OF A CRIME?

X No
__

__ Yes

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were
committed, sentence(s) imposed, and type(s) of rehabilitation. __________________________________________________
____________________________________________________________________________________________________

PLEASE PRINT ALL

INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT

DO YOU HAVE A DRIVERS LICENSE?

X No
__ Yes __
Walking or biking

What is your means of transportation to work? _______________________________________________________________

Drivers license
number ____________________________ State of issue _______
Expiration date ______________________

__ Operator __ Commercial (CDL)

Have you had any accidents during the past three years?
Have you had any moving violations during the past three years?

__ Chauffeur

How many? ___________________

How Many? ___________________

OFFICE ONLY

Typing

__ Yes
__ No

Personal
Computer

__ Yes
__ No

_____ WPM

__ Yes
10-key __ No

__ PC
__ Mac

Word
Processing

__ Yes
__ No

_____ WPM

Other _____________________________________________
Skills ______________________________________________

Please list two references other than relatives or previous employers.

Steven Hendee
Name _______________________________________
Band Director

Linda Victoria

Name _____________________________________________

Position ______________________________________

Repossessions Representative
Position ___________________________________________

Castro Valley Unified School District

Company _____________________________________

Bank of the West

Company __________________________________________

19400 Santa Maria Ave

Address ______________________________________

Address ___________________________________________

Castro Valley CA, 94546

______________________________________

___________________________________________

329-2396
Telephone ( 510)

Telephone (

707) 720-6602

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the
space below to summarize any additional information necessary to describe your full qualifications for the specific position for
which you are applying.

PLEASE PRINT ALL

INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
MILITARY
HAVE YOU EVER BEEN IN THE ARMED FORCES?
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?

x No
__ Yes __
x No
__ Yes __

Specialty ___________________________________ Date Entered ________________ Discharge Date ______________

Work
Experience

Please list your work experience for the past five years beginning with your most recent job held.
If you were self-employed, give firm name. Attach additional sheets if necessary.

Name of employer Linda Victoria

Address
(707) 720-6602
City, State, Zip Code
Phone number

Name of last
supervisor

Your last job title

Employment dates

Pay or salary

From

Start

To

Final

$20

baby sitter

Reason for leaving (be specific) I did not leave. I work for them occasionally.
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this
company. I was responsible for three children all under the age of 9. I provided food, entertainment and above all,

safety. I change diapers and potty train and practice good hygiene with the kids.

Name of employer
Address
City, State, Zip Code
Phone number

Diana Ramirez-Simon
(510) 387-6742

Name of last
supervisor

Your Last Job Title

Employment dates

Pay or salary

From

Start

To

Final

$7/hr

baby sitter

Reason for leaving (be specific) I did not leave. I work for them occasionally.
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this
company.

I was responsible for two kids ages 3 and 5. I provide food, entertainment and above all, safety. I
change diapers and potty train and practice good hygiene with the kids.

PLEASE PRINT ALL

INFORMATION REQUESTED
EXCEPT SIGNATURE
APPLICATION FOR EMPLOYMENT
Work
experience

Please list your work experience for the past five years beginning with your most recent job held.
If you were self-employed, give firm name. Attach additional sheets if necessary.

Name of employer
Address
City, State, Zip Code
Phone number

Mr. & Mrs. Gerardo Victoria

(707)720-6602

Name of last
supervisor

Employment dates

Pay or salary

From

Start

To

Final

Your last job title Music Director

Reason for leaving (be specific) It was an event. Not a long term job.
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this
company.

Discus with employers desired performance. Hire musicians and create a small ensemble fit to the venue and
style of music. Find themed music and arrange popular songs to fit instrumentation. Organize and lead
rehearsals practicing desired style of music.

Steven Hendee
Name of employer
Address
(510)329-2396
City, State, Zip Code
Phone number

Name of last
supervisor

Your last job title

Reason for leaving (be specific)

Employment dates

Pay or salary

From

Start

To

Final

Section Leader

I still work with them seasonally

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this
company.

Organize and educate team of 30 high schoolers. Distribute and assist in reading required materials. Act as an
example displaying proper rhythm and formation. Leads in a variety of environments.

May we contact your present employer?

x Yes __ No
__

Did you complete this application yourself

__x Yes __ No

If not, who did? _______________________________________________________________________________________