Employment Application

Last Name (required):

First Name (required):

M.I

Date:

Street Address:

Apartment/Unit #

City:

State:

Zip:

Phone (required):

Email (required):

Date Available:

Position Applied for:

Are you a citizen of the United States?:

YesNo

If no, are you authorized to work in the U.S.?:

YesNo

Have you ever worked for this company?:

YesNo

If so, when?:

EDUCATION

High School:

Address:

From:

To:

Did you graduate?:

YesNo

Degree:

College:

Address:

From:

To:

Did you graduate?:

YesNo

Degree:

Other:

Address:

From:

To:

Did you graduate?:

YesNo

Degree:

REFERENCES

Please list three professional references

Full Name:

Relationship:

Company:

Phone:

Address:

PREVIOUS EMPLOYMENT

Company:

Phone:

Address:

Supervisor:

Job Title:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?:

YesNo

MILITARY SERVICE

Branch:

From:

To:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.

Sign Here With Your Mouse:

Signature of Applicant (Sign Here With Your Mouse:)

Date

LINEN, UNIFORM & MAT RENTALS

SERVING VT, NH & NY

Employment Application

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

MILITARY SERVICE

DISCLAIMER AND SIGNATURE

“A quality product insures our future.”