PERFORMANCE CHORES LLC
JOB APPLICATION
NAME (Last, First, Middle) SOC. SEC. #
_______________________________________________________ __ __ __ -__ __ __ - __ __ __ __
ADDRESS (Number and Street, City, State, Zip Code) PHONE NUMBER
_______________________________________________________ ____________________________
POSITION DESIRED: Full-time ______ Part-Time _______
_______________________________________________________________ Temporary ______
Do you have a valid drivers license? Yes ______ No ______
Do you have a felony? Yes ______ No _______
EDUCATION
HIGH SCHOOL(NAME AND ADRESS) DEGREE EARNED OR DIPLOMA
___________________________________________________ ________________________________
COLLEGE(Name and Address) DEGREE EARNED OR DIPLOMA
____________________________________________________ _______________________________
TRADE OR BUSINESS SCHOOL(Name and Address) DEGREE EARNED OR DIPLOMA
____________________________________________________ _______________________________
SPECIAL SKILLS AND QUALIFICATIONS: List job-related licenses, skills training, honors, awards, and special accomplishments.
EMPLOYMENT HISTORY: (START WITH PRESENT OR LAST POSITION)
Employer: ___________________________________________________________________________
Address: ____________________________________________________________________________
Supervisor: __________________________________________________________________________
Phone: ______________________________________________________________________________
Position Title: ________________________________________________________________________
From: _________________________________________ To: ______________________________
Duties: ______________________________________________________________________________
Salary/Wage: _______________________________ ____________________________________
(First) (Last)
Reason for Leaving: ___________________________________________________________________
Employer: ___________________________________________________________________________
Address: ____________________________________________________________________________
Supervisor: __________________________________________________________________________
Phone: _____________________________________________________________________________
Position Title: ________________________________________________________________________
From: __________________________________________ To: _______________________________
Duties: ______________________________________________________________________________
Salary/Wages: ________________________________ __________________________________
(First) (Last)
Reason for Leaving: ___________________________________________________________________
Employer: ___________________________________________________________________________
Address: ____________________________________________________________________________
Supervisor: __________________________________________________________________________
Phone: _____________________________________________________________________________
Position Title: ________________________________________________________________________
From: __________________________________________ To: ______________________________
Duties: _____________________________________________________________________________
Salary/Wages: ___________________________________ ________________________________
(First) (Last)
Reason for Leaving: ___________________________________________________________________
MAY WE CONTACT YOU PREVIOUS EMPLOYER? YES _________ NO __________
I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT ANY FALSE INFORMATION ON THE APPLICATION MAY BE GROUNDS FOR NOT HIRING ME. BY
SIGNING THIS APPLICATION, I GIVE AUTHORIZATION TO DO A BACKGROUND CHECK.
DATE: ______________________ SIGNATURE: ________________________________________