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Application for Employment

PERSONAL INFORMATION:

EMPLOYMENT DESIRED:

EDUCATION:

High School:

College:

Trade, Business, or Correspondence School:

FORMER EMPLOYERS:

List below 3 employers, starting with last one first

REFERENCES:

List below the names of 3 persons NOT related to you, whom you have known at least 1 year.

PHYSICAL RECORD:

Do you have any physical conditions which may limit your ability to perform the job applied for?

MILITARY SERVICE:

I authorize investigation of all statements contained in this application. I understand that misrepresentation of omission of facts called for is cause for
dismissal. Further, I understand and agree that 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 any previous notice.

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