Employment

First Name*

Middle Name

Last Name*

Address Line 1*

Address Line 2

City*

State

Phone*

Email*

I am applying for:

Expected Hourly Rate:

Date Available To Report

How Did You Learn About This Position?*

Most Recent Employer

From: (MO/YR)

To: (MO/YR)

Employer Address

Employer City

Employer State

Employer ZIP

Your Position

Description Of Work

Supervisor

Employer Telephone

Reason For Leaving This Employer

Starting Salary (Hourly or Monthly Salary)

Ending Salary (Hourly or Monthly Salary)

Previous Employer

From: (MO/YR)

To: (MO/YR)

Previous Employer Address

Previous Employer City

Previous Employer State

Previous Employer ZIP

Previous Employer Position

Previous Employer Supervisor

Previous Employer Telephone

Reason For Leaving This Previous Employer

Starting Salary (Hourly or Monthly Salary)

Ending Salary (Hourly or Monthly Salary)

Are You 18 Years Of Age Or Older?

Yes

Are you currently employed?

Yes

May we contact present employer?

Yes

Describe any equipment, special training and skills which are in any way related to the kind of position applied for:

Name Of High School

Dates Attended (MO/YR)

Degree Received

Name Of College

Major/Minor Subject

Dates Attended (MO/YR)

Degree(s) Received

Average Grade/GPA

Graduate School

Major/Minor Subject

Dates Attended (MO/YR)

Degree(s) Received

Average Grade/GPA

Vocational School or Trade School

Major/Minor Subject

Dates Attended (MO/YR)

Degree/Certificate Received

Average Grade/GPA

List trades and professional certificates in which you have recognized proficiency or license:

Have you ever been terminated involuntarily?

Yes

When Were You Terminated From This Position?

Employer

Reason For Your Termination From This Position

Have you ever been convicted of a felony offense? *Answer Required

Yes

If yes, list date, charge and city where convicted (including all convictions, civilian or military):

Are you legally authorized to work in the U.S.? (Proof of your identity and authorization to work will be required prior to reporting to work) *Answer Required

Yes

Military Service

Yes

Branch

Rank

Is Active Military(Reserve)

Reference Name

Business or Occupation

Years Known

Reference Address

Reference Telephone

Reference Name

Business or Occupation

Years Known

Reference Address

Reference Telephone

Contact Name

Relationship To Applicant

Contact Telephone

Disclaimer - By signing, I hereby certify that the above information, to the best of my knowledge, is correct. I understand that falsification of this information may prevent me from being hired or lead to my dismissal if hired. I understand and agree that my employment is for no definite time period and that I or Good Time, LLC may terminate my employment at any time with or without cause. I also provide consent for Good Time, LLC to provide background checks into my work, criminal, and financial history to determine suitability for employment.

Employment

Employment Details

Employment History

Education

General

References

Emergency Contact

Pre-employment Statement