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Employment Application
Pre-Employment Questionnaire Equal Opportunity Employer

PERSONAL INFORMATION
Name (Last Name First) PRESENT ADDRESS PERMANENT ADDRESS PHONE NUMBER CITY CITY DATE OF APPLICATION STATE STATE REFERRED BY SOCIAL SECURITY NUMBER ZIP CODE ZIP CODE

EMPLOYMENT DESIRED
POSITION ARE YOU CURRENTLY EMPLOYED? CIRCLE ONE: HAVE YOU EVER WORKED FOR THIS COMPANY? DATE AVAILABLE TO START IF SO, MAY WE CONTACT YOUR EMPLOYER? IF SO, WHERE? YEARS ATTENDED/GRADUATE?
_______ Yrs. / YES YES YES NO NO NO

WAGE DESIRED MIN AND MAX HOURS DESIRED WHEN?

YES YES

NO NO

NAME AND LOCATION OF SCHOOL
HIGH SCHOOL COLLEGE

SUBJECTS STUDIED

_______ Yrs. /

TRADE, BUSINESS, OR OTHER
_______ Yrs. /

GENERAL
SUBJECTS OF SPECIAL STUDY/RESEARCH WORK OR SPECIAL TRAINING/SKILLS

HAVE YOU EVER BEEN CONVICTED OF A CRIME? MILITARY SERVICE? YES NO FROM: FROM: FROM: TO: TO: TO: WHICH BRANCH?

YES

NO

EXPLAIN: RANK

FORMER EMPLOYERS (List below your last four employers, starting with the most recent)
EMPLOYER EMPLOYER EMPLOYER SALARY: SALARY: SALARY: POSITION: POSITION: POSITION: REASON FOR LEAVING REASON FOR LEAVING REASON FOR LEAVING

REFERENCES (Give the names of three persons not related to you; at least one must be a business reference)
NAME NAME NAME PHONE NUMBER PHONE NUMBER PHONE NUMBER BUSINESS BUSINESS BUSINESS YEARS KNOWN YEARS KNOWN YEARS KNOWN

Employment Application
Pre-Employment Questionnaire Equal Opportunity Employer

PRELIMINARY QUESTIONS
WHAT IS YOUR AVAILABILITY FOR THE NEXT 12 MONTHS?

WHAT ARE 5 UNIQUE CHARACTERISTICS YOU POSSESS (IN COMPARISON TO YOUR FRIENDS AND CO-WORKERS) THAT SET YOU APART AND MAKE YOU AN EXCELLENT CHOICE FOR SMOOTHIE KING? 1 2 3 4 5 THIS JOB REQUIRES YOU TO UPSELL, CROSS-SELL, AND ASSIST CUSTOMERS WITH NUTRITIONAL PRODUCTS. CAN YOU TELL US A LITTLE ABOUT ANY SELLING SKILLS THAT YOU HAVE?

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