Employment Application | Milco Industries

Personal Information

Name*

Address*

Phone Number*

Position Applied For:*

Date Available to Start*

Salary Desired:*

Type of Employment Desired:*

Full-Time
Part-Time
Temporary

Are You Employed Now?*

Yes
No

May We Contact Your Present Employer?*

Yes
No

Have You Ever Worked For This Company?*

Yes
No

Dates Employed:

Position:

Reason for Leaving:

Are You Legally Eligible for Employment in the United States?*

Yes
No

Are 18 Years or Older?*

Yes
No

Educational Background

High School

High School Name & Location

High School Years Completed

Did You Graduate?

Yes
No

Course of Study

College

College Name & Location

College Years Completed

Did You Graduate?

Yes
No

Course of Study

Other

Other Name & Location

Other Years Completed

Did You Graduate?

Yes
No

Other Course of Study

Additional Skills / Training / Experience

Special / Job-related skills or qualifications

Military Service:

Yes
No

Military Branch:

Rank:

Present Membership in National Guards or Reserves:

Work Experience

List your last three (3) employers starting with the most recent one

Employer 1

Company 1 Name

Company 1 Address

Company 1 Phone

Company 1 Job Title

Company 1 Supervisor

Employment Dates

Company 1 Employment Date From

Company 1 Employment Date To

Company 1 Hourly Rate/Salary

Company 1 Reason for Leaving

Company 1 Responsibilities

Employer 2

Company 2 Name

Company 2 Address

Company 2 Phone

Company 2 Job Title

Company 2 Supervisor

Employment Dates

Company 2 Employment Date From

Company 2 Employment Date To

Company 2 Hourly Rate/Salary

Company 2 Reason for Leaving

Company 2 Responsibilities

Employer 3

Company 3 Name

Company 3 Address

Company 3 Phone

Company 3 Job Title

Company 3 Supervisor

Employment Dates

Company 3 Employment Date From

Company 3 Employment Date To

Company 3 Hourly Rate/Salary

Company 3 Reason for Leaving

Company 3 Responsibilities

Work References

Reference 1

Reference 1

Reference 1 Company & Title

Reference 1 Phone

Reference 1 Years Known

Reference 2

Reference 2

Reference 2 Company & Title

Reference 2 Phone

Reference 2 Years Known

Reference 3

Reference 3

Reference 3 Company & Title

Reference 3 Phone

Reference 3 Years Known

Authorization

Authorization: I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorized investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have personal or otherwise, and release all parties from all liability for any damage that may result from furnishing the same to you. I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any prior notice.*

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorized investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have personal or otherwise, and release all parties from all liability for any damage that may result from furnishing the same to you.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any prior notice.

I agree with the above statements