Print paper application (requires Adobe Reader)
Full Name:
Telephone No.:
Address:
Email:
City, State, Zip:
High School:
College:
City, State:
Last Grade Completed:
US Citizen?
Yes No
Alien Registration #:
If No, Type of Visa:
What Position are You Applying For?
Check One:
Full Time Part Time
Available
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
From
To
Employer Name and Address
Date From/To
Type of Work Performed
Weekly Salary
Supervisor's Name
Reason for Leaving
May we contact any of the employer's above? Yes No If Yes, please provide phone numbers for any above.
IMPORTANT NOTICE: Working Papers or a Birth Certificate May be Required Prior To Employment.
Are you under the age of 18 or over 70? Yes No Can you supply proof of age? Yes No
Drivers License # Do you have any points on it? Yes No
Can you provide proof of your driving record? Yes No
Have you been convicted of a felony or misdemeanor? Yes No
If Yes, provide dates and details
The facts set forth in my application for employment are true and complete. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. I agree that all individuals supplying information about me, for reference purposes, are released from liablility. If a job opportunity is offered, I shall comply with all of Labor Panes, Inc. uniform requirements. I understand the selection of employees will be on the basis of occupational qualification, education and character without regard to age, sex, race or national origin.