Job Application

Full Name *

Email *

Street Address

City, State and Zip

Phone Number

Date Available

Social Security Number

Position Applying For

Desired Salary

Are you a citizen of the United States?

Are you authorized to work in the U.S.?

Have you ever worked for this company before?

If yes, when?

Have you ever been convicted of a felony?

If yes, explain:

EDUCATION - Please list your high school, college and any trade schools. List the address, dates you attended and if you graduated along with what degrees you earned.

PROFESSIONAL REFERENCE #1- Full Name

Relationship

Company Name

Phone

Address

PROFESSIONAL REFERENCE #2- Full Name

Relationship

Company Name

Phone

Address

PROFESSIONAL REFERENCE #3- Full Name

Relationship

Company Name

Phone

Address

PREVIOUS EMPLOYMENT - Name of Company

Address

Phone

Supervisor

Starting Salary - Ending Salary

Job Title

Responsibilities

Dates of Employment (Start and End Dates)

Reason for Leaving

May we contact your supervisor for a reference?

PREVIOUS EMPLOYMENT - Name of Company

Address

Phone

Supervisor

Starting Salary - Ending Salary

Job Title

Responsibilities

Dates of Employment (Start and End Dates)

Reason for Leaving

May we contact your supervisor for a reference?

MILITARY SERVICE Please list your branch

Service Dates

Rank at Discharge:

Type of Discharge

If other than honorable, please explain:

Online Signature and Disclaimer

By typing my name above, I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. In Virginia, employment is “at will,” meaning, in short, that employers may legally fire an employee at any time, for any reason, without cause. Likewise, an employee is free to quit at any time. Neither the employer nor the employee is required to provide any notice in advance

Date / Time

HOURS

DIRECTIONS

QUICK LINKS

McDRAKE ENTERPRISES LLC