Position
Applied For:
I.
Personal Information:
Full Name:
Street Address:
City:
State:
Zip Code:
Telephone Number:
-
(Area Code) (Phone Number)
Email Address:
1. Is there any information we would
need about your name or use of another name for us
to be able to check your work record?
No
Yes
If yes, please specify:
2. Do you have any relatives who
are presently (or have formerly been) employed by
Maddox Marketing Group?
No
Yes
If yes, who?
3.How were you referred to Maddox
Marketing Group?
4. Have you ever been convicted of
a felony?
No
Yes
If yes, please explain:
II.
Educational History:
School Name/Location
Years Completed
College
Other
Degree/Diploma
III.
Employment History: Please
include all employment for the last five years.
Employer
#1 (Current or Most Recent Employer)
Company Name:
Position Held:
Address:
Dates Employed:
-
(From/ To)
Manager / Supervisor:
Telephone Number:
-
(Area Code) (Phone Number)
Wage/Salary:
Reason For Leaving:
Employer
#2
Company Name:
Position Held:
Address:
Dates Employed:
-
(From/ To)
Manager / Supervisor:
Telephone Number:
-
(Area Code) (Phone Number)
Wage/Salary:
Reason For Leaving:
Employer
#3
Company Name:
Position Held:
Address:
Dates Employed:
-
(From/ To)
Manager / Supervisor:
Telephone Number:
-
(Area Code) (Phone Number)
Wage/Salary:
Reason For Leaving:
NOTE: Use this area
to list additional employers, if necessary.
We will contact
all of the employers listed on this application unless
you specifically exclude them below.
Please list any employers
you do not want us to contact and your reason for
the exclusion:
IV.
Work Availability
1. If your application receives favorable
consideration, when would you be available to begin
work?
2. Do you have any objection to working
overtime?
No
Yes
Can you work overtime without prior notice?
No
Yes
Can you work on Saturday?
No
Yes
5. Can you work on Sunday?
No
Yes
6. Can you travel if required by this
position?
No
Yes
Do you have any outstanding employment contracts and/or
non-compete agreements?
No
Yes If yes, please explain:
If required by your position with Maddox Marketing
Group, would you be willing to sign a non-compete
agreement?
No
Yes
V.
Compensation Requirements
1. If your application receives favorable
consideration, what annual salary/hourly rate would
you require?
$
per
Your most recent annual earnings:
VI.
Computer Skills and Qualifications
1. What computer platform(s) are
you most experienced?
Mac
PC/Windows
Unix
Other:
2. How would you rate your computer
proficiency?
No Experience
Novice
Proficient
Expert
3. Please list the computer software
programs and versions that you have working knowledge
of:
VII.
Special Skills and Qualifications
Summarize special job-related skills
and qualifications acquired from employment or other
experience that will differentiate you from other
applicants:
VIII. Additional
Information Or Comments:
Use this space to provide any additional
information which you feel would be helpful to Maddox
Marketing Group in their evaluation of this application
for employment.
I certify that answers given herein are
true and complete to the best of my knowledge. I authorize
investgation of all statements contained in this application
for employment as may be necessary in arriving at an
employment decision. This application for employment
shall be considered active for a period of time not
exceed 45 days. Any applicant wishing to be considered
for employment beyond this time period should inquire
as to whether or not applications are being accepted
at that time. In the event of employment, I understand
that false or misleading information given in my application
or interview(s) may result in discharge. I understand,
also, that I am required to abide by all rules and
regulations of the employer.
I Agree
I Do Not Agree