Makson General Employment Application Form

Your Personal Information

Your Name(Required)

First Middle Last

Your Email Address(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State ZIP Code

Cell Phone(Required)

Home Phone

Position applying for

Availability(Required)

Full Time

Part Time

Temp

Available Start Date(Required)

Are You Currently Employed?(Required)

Yes

Are You Under Age 18?(Required)

Yes

Have You Ever Been Employed By This Organization In The Past?(Required)

Yes

Do You Have Any Relatives Working Here?(Required)

Yes

Previous Employment

Please list ALL work experience beginning with your most recent job held.

Untitled

Company	Address	Phone	Name of Last Supervisor	Hours per Week	Start Date	End Date	Starting Salary	Final Salary	Your Last Job Title	Reason for leaving (be specific)	List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	May we contact this employer?	Actions

There are no Entries.

Maximum number of entries reached.

More About You

I certify that I am a U.S. Citizen, permanent resident, or a foreign nation with authorization to work in the United States(Required)

Yes

Have you ever been convicted of, or entered a plea of guilty, no contest, or had a withheld judgment to a felony?(Required)

(A conviction does not mean you cannot be hired)

Yes

Please Explain(Required)

Do you have a driver's license?(Required)

Yes

Types of Equipment or Software that you are proficient with

Education

High School

Please list the School, Location (mailing address), and years completed

College or Business/Trade School

Please list the School, Location (mailing address), years completed, Major and Degree/Diploma

Military

Have you ever been in the Armed Forces?(Required)

Yes

Please provide your Specialty, Entered Date, Discharge Date and Discharge status(Required)

Are you now a member of the National Guard?(Required)

Yes

Please provide your Entered Date, Discharge Date and Discharge status(Required)

References

Please provide three references that we can contact and who are able to evaluate your professional knowledge and abilities:

Reference #1

Name

First Last

Company

Address

Street Address Address Line 2 City State ZIP Code

Rerlationship

Phone

Reference #2

Name

First Last

Company

Address

Street Address Address Line 2 City State ZIP Code

Rerlationship

Phone

Reference #3

Name

First Last

Company

Address

Street Address Address Line 2 City State ZIP Code

Rerlationship

Phone

Disclaimer & Signature

I certify that my answers are true and complete to the best of my knowledge. I understand and agree that employment with this company, if offered, may be immediately discontinued if misrepresentation, false statements or material omissions are found to have been made. I hereby authonze educational institutions, former employers and former supervisors to provide any and all information pertinent to my being considered for employment and hereby release those providing such information from any liability for doing so, I understand that employment, if offered, is contingent upon my providing proof of identity and employment eligibility by completing a 1-9 form. I understand that, if employed, the company or I may terminate the employment relationship at any time, with or without cause, with or without notice, and that if employed, employment does not constitute a contract of employment between myself and the company. If employed, I will abide by and conform to all company policies, rules and procedures as may be in effect from time to time. I have read the above, understand its content and meaning, and agree to all of this provisions. By signing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature

Signature(Required)

Your Name
Your Name
Your Name

Date