Employment Application

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Download Employment Application PDF

Personal Information

First Name

Last Name

Primary Phone

Address

City

State

ZIP

Employment Desired

What shifts are you available for (Select all that apply)

Full-Time Part-Time Temporary Intern

How did you learn about us?

What shift(s) are you willing to work

1st 2nd Any

Date available for work?

Position Applying For

Desired Wage?

Have you applied here before? If yes, give estimated date

Have you previously been employed by Pro-label?

Yes No

If yes, provide dates employed, location, and name of supervisor

Do you have relatives employed by Pro-label?

Yes No

If yes, provide name, location, and position

Are you either a U.S. Citizen or an alien authorized for work in the United States?

Yes No

Are you at least 18 years of age?

Yes No

If yes, what is your birth date?

In the last 7 years, Have you been convicted of a criminal offense other than a minor traffic violation?

Yes No

Please Explain

Education

High School

Address of High School

Did you graduate High School?

Yes No Attending

If no, have you passed a high school equivalency or GED exam?

Yes No

Secondary Education

Business or Technical College

Major Field

Did you graduate Business or Technical College?

Yes No Attending

College or University

Major Field

Did you graduate College or University?

Yes No Attending

List any additional education or training relevant to the position you seek:

List any educational honors or pertinent professional affiliations and activities relevant to the position you seek:

Employment Experience

Start with your current or most recent job

Employer*

Phone

Full-Time or Part-Time?

Job Title

Supervisor

Address

Start Pay

End Pay

Date Employed

Describe your primary duties

Reason for Leaving

Were you involuntarily discharged?

Yes No

If you are currently employed, may we contact this employer?

Yes No

Employer 2

Employer

Phone

Full-Time or Part-Time?

Job Title

Supervisor

Address

Start Pay

End Pay

Date Employed

Describe your primary duties

Reason for Leaving

Were you involuntarily discharged?

Yes No

May we contact this employer?

Yes No

Employer 3

Employer

Phone

Full-Time or Part-Time?

Job Title

Supervisor

Address

Start Pay

End Pay

Date Employed

Describe your primary duties

Reason for Leaving

Were you involuntarily discharged?

Yes No

May we contact this employer?

Yes No

I certify that the foregoing information is correct and complete, and PRO-LABEL INC may terminate my employment for falsification of statements, answers or material omissions made by me in this employment application. I authorize The PRO-LABEL INC to investigate these statements, references, previous employers and school records and authorize the release of such information without liability. I understand that any job offer would be contingent upon successful completion of a pre-employment drug test and a 90 day introductory period. I further understand that employment and compensation can be terminated with or without cause at any time at the option of PRO-LABEL INC or myself.

Electronic Signature of Applicant

Date

Employment Application

Personal Information

Employment Desired

Education

Employment Experience

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