Employment Application

Position you are seeking (you must fill out one application for each position you are applying for)

First name *

Last name *

Middle name

Address

City

State

Zip

Phone number *

Email address *

Have you ever filed an application here before?

Yes

No

If yes, please give date:

Month

Day

Year

Do any of your friends or relatives other than a spouse work here?

Yes

No

If yes, please give name, relationship, and position:

Are you at least 18 years of age?

Yes

No

If you are under 18 years of age, can you provide proof of your eligibility to work?

Yes

No

Are you a US citizen?

Yes

No

If not a US citizen, do you have proof of your legal right to accept employment?

Yes

No

Are you currently on a lay-off status and subject to recall?

Yes

No

Do you have a valid driver's license?

Yes

No

Will you work overtime?

Yes

No

Have you ever been convicted of a crime?

Yes

No

If yes, please give date and reason for conviction:

(All positions at SOEX are subject to a Criminal Background Check)

Are you capable of performing with or without reasonable accommodation, the essential duties of the job for which you are applying? (Do not answer unless you have read the job description.)

Yes

No

Date available for work:

Month

Day

Year

What is your desired starting hourly wage?

Education & Training:

High school (Name, City, and State)

Diploma from high school?

Yes

No

Degree from undergraduate school?

Yes

No

Undergraduate school (Name, City, and State)

Undergraduate school course of study

Number of years at undergraduate school

Other education (please provide details)

Please state any additional information and skills you feel may be helpful to us in considering your application:

Work experience - Complete this section even if you are attaching a resume

Begin with your current or last job. Include any job-related military service assignments and volunteer activities. You may exclude any organizations that indicate race, color, religion, gender, national origin, disabilities, or other protected status.

Job 1:

Employer

Job title:

Employed from (date):

Month

Day

Year

Employed to (date):

Month

Day

Year

Address

Starting Hourly / Salary Rate:

Ending Hourly / Salary Rate:

Work performed/responsibilities:

Supervisor & Telephone #

May we contact?

Yes

No

Reason for leaving:

Job 2:

Employer

Job title:

Employed from (date):

Month

Day

Year

Employed to (date):

Month

Day

Year

Address

Starting Hourly / Salary Rate:

Ending Hourly / Salary Rate:

Work performed/responsibilities:

Supervisor & Telephone #

May we contact?

Yes

No

Reason for leaving:

Job 3:

Employer

Job title:

Employed from (date):

Month

Day

Year

Employed to (date):

Month

Day

Year

Address

Starting Hourly / Salary Rate:

Ending Hourly / Salary Rate:

Work performed/responsibilities:

Supervisor & Telephone #

May we contact?

Yes

No

Reason for leaving:

References

Reference 1:

Name

Phone number

Relation

Reference 2:

Name

Phone number

Relation

Reference 3:

Name

Phone number

Relation

Leave this field blank