Thomsens is an Equal Opportunity Employer
All qualified applicants will receive consideration without regard to race, color, creed, religion, sex, national origin, age, disability, marital or veteran status, or any other characteristic protected by State or Federal law. |
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| POSITION APPLYING FOR
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| PERSONAL INFORMATION |
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| Date
Social Security Number
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| Last Name
Middle Initial
First Name
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| Present Street Address
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| City
State
Zip
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| Home Phone
Cell Phone
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| Business Phone
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| Email Address
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| Have you ever applied for employment with Thomsens in the past?
Yes
No |
| If Yes, when and for what position?
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| Have you ever been employed with Thomsens?
Yes
No |
| If Yes, when, for what position, and under what name?
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| EMPLOYMENT DESIRED |
| Position
Wage Expected
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Full-Time
Part-Time
Seasonal
Regular |
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| Days and Hours available: |
| Mon
Tue
Wed
Thu
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| Fri
Sat
Sun
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| Months available to work: |
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Jan
Feb
Mar
Apr
May
Jun
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Jul
Aug
Sep
Oct
Nov
Dec
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| Date available to start work
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| Hours per week desired
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| Will you work overtime if asked?
Yes
No |
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| Are you acquainted with anyone who works for Thomsens?
Yes
No |
| If yes, who?
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Please provide a complete full time and part time employment record.
PRESENT OR MOST RECENT EMPLOYER |
| Company Name
Telephone
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| Address (include City, State & Zip)
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| Name of Supervisor
Employed: From
To
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State Job Title & Describe Your Work
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| Reason for Leaving
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| Is there a reason why you would not want us to contact this employer?
Yes
No |
| If yes, please explain
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| SECOND MOST RECENT EMPLOYER |
| Company Name
Telephone
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| Address (include City, State & Zip)
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| Name of Supervisor
Employed: From
To
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State Job Title & Describe Your Work
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| Reason for Leaving
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| Is there a reason why you would not want us to contact this employer?
Yes
No |
| If yes, please explain
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| THIRD MOST RECENT EMPLOYER |
| Company Name
Telephone
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| Address (include City, State & Zip)
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| Name of Supervisor
Employed: From
To
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State Job Title & Describe Your Work
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| Reason for Leaving
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| Is there a reason why you would not want us to contact this employer?
Yes
No |
| If yes, please explain
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| EDUCATION |
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Additional job related seminars, short courses, workshops or other education experiences?
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Please list any job-related clubs, professional societies, or other associations to which you belong?
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| SKILLS |
Please summarize any special skills or training you may have that would qualify you for the position for which you are applying.
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REFERENCES
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APPLICATION AGREEMENT
I hereby certify that the information I have provided in this employment application is true and correct to the best of my knowledge, and that I have not withheld information that would, if disclosed, affect this application unfavorably. I understand that falsified or intentionally misleading information or significant omissions from this application may disqualify me from further consideration for employment or may result in my termination if discovered after my hire. I agree that Thomsen’s shall not be liable for disqualifying or terminating me under such circumstances. I authorize Thomsen’s to investigate my personal, educational, and employment history. I understand that my employment is “At Will” and can be terminated by either me or the company for any reason, with or without notice consistent with state or federal law. This “employment at will” policy cannot be changed verbally or in writing, unless the change is specifically authorized in writing by the President of the Company. |
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I have read the above Application Agreement, and understand and agree to its terms.
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