Employment | Bobby Page's Dry Cleaners and Shirt Laundry

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Personal Information
First Name		Last Name
Address		City
State		ZIP
Phone #		Email Address
Mode of Transportation		Position Applying For
Experience	Yes No	Salary Desired
Are You Employed	Yes No	Have You Applied Here Before	Yes No
Please list all skills or training that apply to the job for which you are applying
Education
School		Years Attending
Did You Graduate	Yes No	Major
School		Years Attending
Did You Graduate	Yes No	Major
School		Years Attending
Did You Graduate	Yes No	Major
Former Employers
From (Month & Year)		To (Month & Year)
Name		Address
Salary		Position
Reason for Leaving
From (Month & Year)		To (Month & Year)
Name		Address
Salary		Position
Reason for Leaving
From (Month & Year)		To (Month & Year)
Name		Address
Salary		Position
Reason for Leaving
Authorization
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act. (ADA) and other relevant federal and state laws.”