Personal Information
* First Name:   *Middle Initial   *Last Name:
* Email:    Social Security #:  
* Current Address:   * City/State/Zip:   
* How long have you resided in this state?   
 Home Phone:    When may we call?  
 Are you an U.S citizen or authorized to work  in the U.S?  
 How did you hear about this company and/or this position?(check one):
News Ad     Relative     Friend     Other(please specify)
 Have you been employed by this company in  the past?  
 Relatives employed by this company?  

Employment Desires
Position applied for: 1.
2.
Date Available: Are you currently employed?
If so, may we inquire of your present or past employers?

Previous Employment Experience
List below your past and present employers, starting with present or most recent employer first.
1. Date (Mo/YR) Company's Name and Address
From:
To:
Position Held: Reason for leaving:
Supervisor: Starting/Ending Salary:

2. Date (Mo/YR) Company's Name and Address
From:
To:
Position Held: Reason for leaving:
Supervisor: Starting/Ending Salary:

3. Date (Mo/YR) Company's Name and Address
From:
To:
Position Held: Reason for leaving:
Supervisor: Starting/Ending Salary:

Qualifications and Education
You are not required to answer any educational questions unless they are directly related to the position or job for which you are applying. If you are applying for a janitorial position, you do not have to fill out the questions concerning grammar school and high school.
How many years of grammar school did you attend?
Name and address of high school
Did you graduate? Major course of Study:
Typing (WPM):
List any computer experience:
Did you ever attend a technical or trade school?
If yes, did you receive a certificate of completion?
Name and address of school:
List any special skills or training you have relating to the position you are seeking:
Can you operate any office or factory machinery?(Please Specify)
Do you possess a valid driver's license? Type/State:

Candidate Information Authorization
I hereby authorize Tell Tool, Inc. and its designated representatives to conduct a comprehensive review of my background for employment purposes.
I understand that the scope of the background check may include, but is not limited to, the following areas:
Verification of social security number; employment history; education; professional references; criminal history records; motor vehicle records; and any other public records.
I authorize, without reservation, any party or agency contacted by Tell Tool, Inc. or its representatives to furnish the above mentioned information.

Military Service
If you served in the armed forces of the U.S., list below what education or skills, if any, you acquired while in U.S. military service that you believe are related to the position for which you are applying?

Mental and Physical
Do you have any physical or mental impairment which would require us to make accommodations for you to perform the job for which you are applying?
If yes, please specify below:
Have you ever been convicted of a felony which is substantially related to your ability to perform the job for which you are applying?
If yes, please state date(s) and circumstances:

Application Agreement
I understand that false or misleading statements or omissions on this application may be considered sufficient cause for dismissal, whenever they may be discovered. I understand that if hired, employment is at will. This means that I may leave the Company, or the Company may terminate my employment, at any time and for any reason, or for no reason at all, with or without notice.

I also understand that the use of this application form does not indicate that there are any positions open and does not, in any way, obligate the Company. And further, in order that the Company be fully informed as to my qualifications for employment, I hereby request and authorize my former employers and other persons who may have information regarding my qualifications to furnish you with such information, and inasmuch as this information is furnished at my express request for my benefit, I agree to hold harmless said persons and former employers on account of furnishing such information.

I agree that a full transcript of my record as an employee, information as to my ability and also the cause of my leaving the Company, if any, may be given to any person with whom I may hereafter seek employment, and I hereby release the Company from any and all liability for damages of any nature by reason of the furnishing of such information.

I have read the above information and agree to all circumstances mentioned.
Date:

We are and equal opportunity employer. Consideration for employment practices are based only on job related occupational qualifications and are not based on race, religion, age, color, national origin, sex, sexual preference, disability, or handicap.
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