City:
State:
ZIP Code:
Telephone:
Alternate Telephone:
E-mail:
First Name:
Middle Initial:
Last Name:
Street Address:
Primary position applied for: |
Skills and Qualifications:
Summarize any special training, skills, licenses, and/or certificates
that may qualify you as being to perform job-related functions in the
position for which you are applying.
Computer
Skills (Check appropriate boxes. Include software titles and years of experience.)
Word Processing
Years
Spreadsheet
Years
Presentation
Years
E-mail
Years
Internet
Years
Other
Years
Other
Years
Applicant Statement:
I certify that all information I have
provided in order to apply for and secure work with the
employer is true, complete and correct.
I understand that any information provided by me that
is found to be false, incomplete or misrepresented in
any respect, will be sufficient cause to (1) cancel further
consideration of this application, or (2) immediately
discharge me from the employer's service, whenever it
is discovered.
By submitting this form I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.