EMPLOYMENT Employment Application (Silver Lake) Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Emergency Contact Name* First Last Emergency Contact Phone*Are you 18 years of age or older?*Choose OneYesNoAre you 16 years of age or older?*Choose OneYesNoIf no, can you provide a work permit?*Choose OneYesNoIf hired, can you provide written evidence that you are authorized to work in the U.S.?*Choose OneYesNoEDUCATIONAdd High School?Choose OneYesNoHigh SchoolSchool Name Course of Study Years Completed Degree/Diploma Add College?Choose OneYesNoCollegeSchool Name Course of Study Years Completed Degree/Diploma Add Technical School or Other?Choose OneYesNoTechnical or OtherSchool Name Course of Study Years Completed Degree/Diploma EMPLOYMENT RECORDAdd Employment Experience?Choose OneYesNoExperience #1Company Name Position Date Started Date Left Pay Rate Reason for Leaving Contact Person Name First Last Contact Person PhoneAdd a 2nd Employment Experience?Choose OneYesNoExperience #2Company Name Position Date Started Date Left Pay Rate Reason for Leaving Contact Person Name First Last Contact Person PhoneAdd a 3rd Employment Experience?Choose OneYesNoExperience #3Company Name Position Date Started Date Left Pay Rate Reason for Leaving Contact Person Name First Last Contact Person PhoneMILITARY EXPERIENCEAdd Military Experience?Choose OneYesNoBranch of Service Date Started Date Left Rank and Type of Service REFERENCESWe require 4 references. Do not include relatives. Include teachers, coaches, church leadership or previous employers.Reference #1Name* First Last Occupation* Years Known* Phone*Reference #2Name* First Last Occupation* Years Known* Phone*EMPLOYMENTType of work desired:* Salary desired:* Date you can start:* Number of hours you wish to work each week:* Have you ever been warned, disciplined or discharged for sexual harassment, fighting, assault or attendance?*Choose OneYesNoExplain below:*Please list any miscellaneous experience that may help you succeed in the job you are seeking:AVAILABILITYTo be considered for most positions you must be available to work weekends (Friday, Saturday, and Sunday). Please use time options from 12:00am to 12:00pm in 30 minute increments.Monday From:* Monday To:* Tuesday From:* Tuesday To:* Wednesday From:* Wednesday To:* Thursday From:* Thursday To:* Friday From:* Friday To:* Saturday From:* Saturday To:* Sunday From:* Sunday To:* MISCELLANEOUSHow were you referred to our organization?*Choose OneWebsiteAdvertisementFriend/FamilyCurrent EmployeeOtherOther:* Is there any information we need about your name or use of another name to check your work record?*Choose OneYesNoPlease specify:*Have you ever been convicted of a felony?*Choose OneYesNoPlease specify:*For summer help, can you work through Labor Day?*Choose OneYesNoCAPTCHA