Beacon Hill Preparatory Institute
Employment Application
Personal Information
Date *
MM
/
DD
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YYYY
First Name *
Your answer
Last Name *
Your answer
Middle Initial *
Your answer
Social Security Number *
Your answer
(Permanent) Address *
Your answer
State *
Your answer
City *
Your answer
Previous Address - If you have not been at current address for more than 5 years
(Previous) Address
Your answer
(Previous) State
Your answer
(Previous) City
Your answer
Telephone *
Home
Your answer
Telephone *
Cell
Your answer
Are you 18 years or older? *
Are you prevented from lawfully becoming employed in this country because of visa or immigration status? *
Position applied for *
Your answer
Salary desired *
Please be specific.
Your answer
Date you can start? *
MM
/
DD
/
YYYY
Are you employed now? *
If so, may we contact your current employer?
Have you ever applied to this company before? *
If yes, where and when.
MM
/
DD
/
YYYY
Educational History
Educational History *
Yes
No
Highschool
Some College
Bachelors 
Masters 
Name of School *
High School or College
Your answer
State (School) *
High School or College
Your answer
Degree
Degree Type
Your answer
Graduated or Earned Degree *
High School or College
yes
no
Received Diploma
Date of Graduation *
MM
/
DD
/
YYYY
Military History
Have you ever been in the Armed Forces?
Branch of Service
Your answer
Date Entered
MM
/
DD
/
YYYY
Date Discharged
MM
/
DD
/
YYYY
Are you now a member of the National Guard?
Employment Information
(Current Employer)
Company Name *
Your answer
(Current) Job Title *
Your answer
(Current) Company Address *
Your answer
(Current) Company Phone Number *
Your answer
(Current) Starting Salary *
Your answer
(Current) Ending Salary *
Your answer
(Previous Employer)
Company Name *
Your answer
(Previous) Job Title *
Your answer
(Previous) Company Address *
Your answer
(Previous) Company Phone Number *
Your answer
(Previous) Starting Salary *
Your answer
(Previous) Ending Salary *
Your answer
References
Please list two references other than relatives or friends
(First Reference)
Reference First Name *
Your answer
Reference Last Name *
Your answer
Reference Company Name *
Your answer
Relationship to Reference *
Your answer
Reference Phone Number *
Your answer
Reference Email *
Your answer
References First Name *
Your answer
(Second Reference)
References Last Name *
Your answer
Reference Company Name *
Your answer
Relationship to Reference *
Your answer
Reference Phone Number *
Your answer
Reference Email *
Your answer
Additional Info
Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.
Additional Information
Your answer
Are you a Citizen of the United States *
If No, Are you Authorized to work in the U.S? *
Have you ever been convicted of a crime? *
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Your answer
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By clicking submit "I certify that all the information on this application is true and complete, and I understand that if any false information, omissions or misrepresentations are discovered, my application may be rejected and, if I am employed my employment may be terminated at any time. In consideration of my employment I agree to conform to the company's rules and regulations and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative other than its president and then only when in writing and signed by the president has any authority to enter into any agreement for employment for any specific period of time or to make any agreement contrary to the foregoing"
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