Application for Employment
Pre-employment Questionnaire
Senior Partners is an Equal Opportunity Employer
PERSONAL INFORMATION
Thank you for your interest in Senior Partners, please fill out this application in its entirety. We look forward to getting to know you better.
Name *
(Last Name First)
Your answer
Present Address *
Your answer
Your Email *
Your answer
Phone number (Include Cell Phone) *
Your answer
18 Years or Older? *
Have you had a misdemeanor or felony conviction? *
Required
Employment Desired
Position *
Your answer
Salary Desired *
Your answer
Date Available to Start *
MM
/
DD
/
YYYY
Days Available *
Required
How did you hear about Senior Partners? *
Your answer
Education History
High School *
Your answer
Graduate *
College
Your answer
Degree
Your answer
Graduate
Trade, Business or Correspondence School
Your answer
Employment History
List below last three employers, starting with last one first
Company Name (#1)
Your answer
Address
Your answer
Phone
Your answer
Dates Employed (from Mo/Yr to Mo/Yr)
Your answer
Job Title
Your answer
Supervisor
Your answer
Duties
Your answer
Salary
Your answer
Reason for Leaving
Your answer
Company Name (#2)
Your answer
Address
Your answer
Phone
Your answer
Dates Employed (from Mo/Yr to Mo/Yr)
Your answer
Job Title
Your answer
Supervisor
Your answer
Duties
Your answer
Salary
Your answer
Reason for Leaving
Your answer
Company Name (#3)
Your answer
Address
Your answer
Phone
Your answer
Dates Employed (from Mo/Yr to Mo/Yr)
Your answer
Job Title
Your answer
Supervisor
Your answer
Duties
Your answer
Salary
Your answer
Reason for Leaving
Your answer
May We Contact Your Present Employer?
Professional License or Certifications
Do you have a Professional License or Certification?
If yes, please list below
Your answer
References
Give below the names of three persons not related to you, whom you have known at least one year.
Name (#1)
Your answer
Phone and Email Address
Your answer
Years Known
Your answer
Name (#2)
Your answer
Phone and Email Address
Your answer
Years Known
Your answer
Name (#3)
Your answer
Phone and Email Address
Your answer
Years Known
Your answer
Authorization and Disclaimer
"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 any 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."

Signature
Please type in your FIRST and LAST name below as your electronic signature: *
Your answer
Today's Date: *
MM
/
DD
/
YYYY
Cover letter (optional)
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy