Employment Application

First Name:
Middle Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone Number:
Are You Eighteen Years Old or Older:
Drivers License Number:
Position Desired:
Desired Start Date:
 Select Date
Current Salary:
Are You Employed Now:
May We Inquire of Your Present Employer:
Have You Worked for Us Before:
If so, When:

Education: Include all schools attended, the names and locations of those schools, and any courses, special training, certifications, or degrees received.

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References: Include the names of at least three persons not related to you, whom you have known at least one year

Enter in the box below:

Former Employers: List your last four employers, starting with the last one first. Include your date of employment, name and address of the employer, salary, position, and reason for leaving.

Enter in the box below:

Signature:

I authorize investigation of all statements contained in this application. I understand that misrepresentation or 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 previous notice.

Southern Manufacturing is an Equal Opportunity Employer.

Signed Date:
 Select Date
Full Signature: