Employment Application Form
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Todays Date *
MM
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DD
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YYYY
Last Name *
First Name *
Middle *
Address *
City *
State *
Birthdate *
MM
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DD
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Phone number *
Do you have a valid Drivers license? *
Required
Drivers License State
Expiration Date
MM
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DD
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YYYY
The Position I am applying for *
Date I can start *
MM
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DD
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Desired salary/wage *
Have you ever applied at Dreamz Work before? *
If yes, under what name(s)?
Availability: Check all that apply *
Required
Education
High school
High School Address
High School Diploma *
College *
College Address *
College Degree *
Other schooling
Describe any other training, skill, and/or  life experiences which you feel are relevant for this position *
Employment & Other Experiences
1. Current or most recent - if we can contact this employer *
Employer Name and Address *
Telephone number *
Supervisor Name *
Job title *
Wage/ Salary Start to Final *
Employed from  to *
Work Preformed *
Reason for Leaving *
2. Employer Name and Address *
Telephone number *
Supervisor Name *
Job title *
Wage Salary start/ final *
Employed (gives date ) *
MM
/
DD
/
YYYY
Worked Preformed *
Reason for Leaving *
3. Employer name and address *
Telephone Number *
Supervisors name *
Job title *
Wage/Salary: start finish *
Employed gives date *
Worked preformed *
4.  Job Title
Wage salary: start to finish
Employed from stat to finish
Work Preformed
Reason for leaving
References: please give the name address and telephone number of (3) references who are NOT already listed, are NOT RELATED to you and have knowledge of your skills and abilities. (teachers, Pastors, youth coordinator, volunteer coordinators).
1st Reference *
Telephone number *
2nd Reference *
Telephone Number *
3rd Reference *
Telephone number *
Applicant's Statement
I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I herby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will"  nature which means that the employee may resign at ant time and the employer may discharge the employee at any time with or with out cause. It is further understood  that this "at will" employment relationship may not be changed by any written document or by conduct unless such a change is specifically acknowledge in writing by an authorized executive of this organization. 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 also understand that job made to me will be contingent on results from a drug screen, physical and functional placement exams, state records check for substantiated instance of abuse & neglect, and criminal history check, including fingerprints. Additionally, I give permission for my driving recorded to be checked if the requires driving a vehicle.
Do you agree to the statements above *
Signature *
Submit
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