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Position Applying For:

Name(Last, First, Middle):

Other names under which you have attended school or been employed:

Street Address:

City, State & Zip:

Social Security Number:

Home Phone:

Work Phone:

Other Phone:

Are you eligible to work in the United States?

Yes

Are you 18 years of age or older?

Yes

Are you currently employed at (We See You LLC)?

Yes

Have you ever been employed by (We See You LLC)?

Yes

Are you related to any current (We See You LLc employee)?

Yes

If required for position, do you have a valid driver’s license?

Yes

How did you learn about this employment opportunity at?

Ad in newspaper

Job Bulletin (Posting) /Walk-in Website

Dept. of Labor

Ad in magazine

Referral by employee

Other

Education

Name of High School:

City/State:

Did you Graduate?

Yes

Degree received:

Major:

Name of GED School:

City/State:

Did you Graduate?

Yes

Degree received:

Major:

Name of Other School:

City/State:

Did you Graduate?

Yes

Degree received:

Major:

Name of College:

City/State:

Did you Graduate?

Yes

Degree received:

Major:

Other credentials/licenses/professional affiliations, etc., which are relevant to the job for which you are applying:

Please list technical skills, clerical skills, trade skills, etc., relevant to this position. Include relevant computer systems and software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert)

Work Experience

Please detail your entire work history. Begin with your current or most recent employer. If you held multiple positions with the same organization, detail each position separately. Please explain any gaps in employment. Include full-time military or volunteer commitments. Please note: We See You LLC reserves the right to contact all, current, and former employers for reference information.

Employer’s Name:

Title:

Dates Employed (most recent position):

Full Time

Part Time

Starting Salary:

Final Salary:

Organization Name and Address:

Supervisor’s Name, Title and Phone #:

Other Reference Name, Title and Phone #:

Contact my current references:

At any time

Only if I am a finalist candidate

Primary duties:

Reason for Leaving:

Please read carefully and check the box that you understand and accept this information:I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize {We See You LLC } to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of {We See You LLc} serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States

Date:

Application for Employment

Education

Work Experience

New Jersey

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