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application for employment

Please fill in this application and press the Submit button at the bottom to submit your application for employment.
 
Name
Street Address
City, State & Zip
Home phone number
How long at the above address?
Email address
Have you ever applied for employment
with us before?		 Yes No
Are you over 25 years old? Yes No
If not, how old?
What motivated you to apply?

Education
Name of High School attended
Address
Did you graduate? Yes No
Name of college attended
Address
Number of years attended
Majors
Grade point average
Did you graduate? Yes No
Other education or training

References

  

Please list three persons other than relatives and former employers who have
known you for at least three years who can speak about your general character

Reference 1

 Name
Home phone number
Work phone number
   

Reference 2

 Name
Home phone number
Work phone number
   

Reference 3

 Name
Home phone number
Work phone number

Physical Information
Do you have any physical limitations or
handicaps that may limit your ability to
perform the position applied for?
If yes, what can be done to reasonably
accommodate your limitations?
Employment Experience/Work History
Start with your present or your last employer. If you need more space, add it
under "Comments" at the end of this form. If summer or part-time work, please
indicate.

Job 1 (most recent)

 Name of employer
Street Address
City, State and Zip
Phone number
Type of business
Name and title of supervisor
Starting date and Date of leaving
Starting pay and Pay at leaving
Your title and duties
Reason for leaving
   

Job 2

 Name of employer
Street Address
City, State and Zip
Phone number
Type of business
Name and title of supervisor
Starting date and Date of leaving
Starting pay and Pay at leaving
Your title and duties
Reason for leaving
   

Job 3

 Name of employer
Street Address
City, State and Zip
Phone number
Type of business
Name and title of supervisor
Starting date and Date of leaving
Starting pay and Pay at leaving
Your title and duties
Reason for leaving
   

Job 4

 Name of employer
Street Address
City, State and Zip
Phone number
Type of business
Name and title of supervisor
Starting date and Date of leaving
Starting pay and Pay at leaving
Your title and duties
Reason for leaving
   
Typing speed words per minute
List any other experience or skills which
relate to the position you want
   
The following questions require at least a "Yes" or "No" reply:
Convictions

Have you ever been convicted of a
felony?

 Yes No
If yes, give details
Saturdays, Sundays & Holidays

The position for which you are applying requires work on Saturdays, Sundays, and
holidays. The Company's normal working days and hours are:

9:30 AM - 6:30 PM everyday.
Employees' work hours and days off vary.

Are you able and willing to work such a
schedule?

 Yes No
If not, give days and hours you can
work:

Legal Status to work

Can you, after employment, submit proof
of your citizenship or legal right to work
in the United States?
   
Please read carefully the paragraphs below, check the "I Agree" box for each
paragraph, then type your name in the "Signature" box below and fill in the date.
 
I agree I hereby authorize the Company, its agents, representatives or
affiliated companies (collectively "the Company") to investigate and
verify all information provided by me on this application or in support
of my efforts to obtain employment with the Company. I hereby
authorize any prior employer listed on this application and/or any
educational entity listed on this application to disclose to the
company any and all letters, reports and other information related
to my work or educational record, without giving me prior notice of
such disclosure. In addition, I hereby release the Company, my
former employers, and educational entities listed on this application
and all other persons, corporations, partnerships and associations
from any and all claims, demands or liabilities arising out of or in any
way related to such investigation or disclosure.
 
I agree I hereby certify all information provided by me on this employment
application and all other information provided by me in the course of
applying for employment at Copenhagen is truthful and accurate. I
understand that if any information provided by me on this
employment application or any other information provided by me in
the course of applying for employment at Copenhagen if found to be
false, untruthful or misleading, that such will be cause for immediate
rejection of my application for employment. I further understand
that if I am hired as an employee of Copenhagen and at any time
thereafter it is discovered than any information provided by me on
this employment application or any other information provided by me
in the course of applying for employment at Copenhagen is found to
be false, untruthful or misleading, I will be subject to immediate
termination from employment. Notwithstanding the above, I also
understand that if I am offered and accept employment at
Copenhagen, my employment will be employment "at will," which
may be terminated by myself or by Copenhagen at any time with or
without notice and with or without cause.
Signature (Type your full name)
Date:

Press the Submit button when you have completely filled out this form.
 

 
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