Download Employment Application

SOUTHEAST POULTRY INC.
2200 TOWN WEST DRIVE
ROGERS, ARKANSAS 72756
APPLICATION FOR EMPLOYMENT
APPLICATION WILL NOT BE CONSIDERED IF INCOMPLETE OF DOES NOT SHOW
THE EXPERINECE AND/OR TRAINING REQUEST. IF YOU HAVE NO INFORMATION
TO WRITE IN A SECTION PLEASE WRITE N/A.
PLEASE PRINT OR TYPE ALL INFORMATION IN BLUE OR BLACK INK.
CONDITIONS OF EMPLOYMENT ARE STATED AT THE END OF THIS APPLICATION,
PLEASE READ CAREFULLY BEFORE YOU SIGN THIS APPLICATION.
IT IS THE POLICY OF SOUTHEAST POULTRY INC. TO AFFORD EQUAL OPPORTUNITY
TO ALL EMPLOYEES AND APPLICANTS FOR EMPLOYMENT WITHOUT REGARD TO
AGE, RACE, RELIGION, COLOR, GENDER, NATIONAL ORIGIN, MARITAL STATUS,
SEXUAL ORIENTATION, PREGNANCY, DISABILITY OR VETERAN STATUS .
APPLICATION DATE: _________________________
POSITION APPLIED FOR: ___________________________
FULL TIME
PART TIME
TEMPORARY
LEGAL NAME
FIRST NAME: ___________________________________________________________________
LAST NAME: ___________________________________________________________________
SOCIAL SECURITY NUMBER: _____________________________________________
PHONE NUMBER: ___________________________ CELL NUMBER: ______________________
CURRENT ADDRESS:
STREET NAME: _______________________________________________
CITY: _________________________STATE: ________________ ZIP CODE: ____________
ARE YOU AUTHORIZED TO WORK IN THE UNITED STATES?
ARE YOU 18 YEARS OR OLDER?
YES
YES
NO
NO
ANY FRIENDS OR FAMILY MEMBERS EMPLOYED HERE?
NAME: ____________________________________ RELATIONSHIP: _______________________
NAME: ____________________________________ RELATIONSHIP: _______________________
EDUCATION
ARE YOU CURRENTLY ENROLLED IN SCHOOL?
YES
NO
LAST GRADE COMPLETED: _____
HIGH SCHOOL NAME: _________________________CITY: _______________________STATE: ______
COLLEGE/ UNIVERSITY: ______________________ CITY: _______________________ STATE: ______
MAJOR: __________________________________ MINOR: ____________________________
DEGREE/ DATE: _______________________________
HOW DID YOU HEAR ABOUT US?
RADIO
MAGAZINE
FRIEND/FAMILY
OTHER
EXPLAIN______________
HAVE YOU BEEN CONVICTED OF A FELONY OFFENSE WITHIN THE LAST 10 YEARS(DO NOT LIST ANY
CONVICTION THAT HAS BEEN EXPONGED OR WAS RECOGNIZED AS A JUVENILLE RECORD).
YES
NO
IF YES PLEASE EXPLAIN. THIS WILL NOT AUTOMATICALLY BAR AN APPLICANT FROM EMPLOYMENT.
_____________________________________________________________________________________
_____________________________________________________________________________________
WORK EXPERIENCE
1.
EMPLOYER: ___________________________________________________________
ADDRESS: ______________________________________ TELEPHONE: _______________
SUPERVISOR: _____________________________
JOB TITLE/ WORK PERFORMED: ______________________________________________
DATES OF EMPLOYMENT START: _____________________ END: ___________________
REASON FOR LEAVING: _____________________________________________________
2.
EMPLOYER: ___________________________________________________________
ADDRESS: ____________________________________ TELEPHONE: _______________
SUPERVISOR: _____________________________
JOB TITLE/ WORK PERFORMED: ______________________________________________
DATES OF EMPLOYMENT START: _____________________ END: ___________________
REASON FOR LEAVING: _____________________________________________________
3.
EMPLOYER: ___________________________________________________________
ADDRESS: ______________________________________ TELEPHONE: _______________
SUPERVISOR: _____________________________
JOB TITLE/ WORK PERFORMED: ______________________________________________
DATES OF EMPLOYMENT START: _____________________ END: ___________________
REASON FOR LEAVING: _____________________________________________________
PLEASE LIST ANY OTHER EXPERIENCE OR QUALIFICATIONS THAT YOU MAY HAVE THAT WOULD BE
BENEFICIAL FOR THIS POSITION:
______________________________________________________________________________
______________________________________________________________________________