Careers

COMPANY OR EMPLOYER NAME: POSITION APPLIED FOR:
APPLICANT TELEPHONE:
SOCIAL SECURITY NUMBER:
   
YOUR NAME:
  Last First Middle
ADDRESS:   ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE U.S.A?
 YES NO(If yes, verification will be required)
I AM SEEKING A PERMANENT POSITION: YES NO
IF NECESSARY FOR THE JOB I AM ABLE TO:
Are you able to perform the essential functions Work (which shifts)?
of the position with or without accommodations? Work overtime?
 YES NO Provide a valid Alaska Drivers License?
       

       
IF NECESSARY FOR THE JOB, ARE YOU OVER (Please mark one)  14 15 16 18 19 21
I WILL BE ABLE TO REPORT TO WORK DAY AFTER BEING NOTIFIED THAT I AM HIRED.
       

       
EDUCATION:   Yrs. Completed Field of Study Graduate or Degree
High School
College/University
Business/Technical
Other (May include grammar school)

       
MILITARY SERVICE:  YES NO    
Duty/Specialized Training:
       

       
REFERENCES: List two personal references who are not relatives or former supervisors.
Name Address Telephone Occupation Years known
Name Address Telephone Occupation Years known

       
EMPLOYMENT: List last employment first. Include summer or temporary jobs. Be sure all your experience or employers jobs
  to this job are listed here, in the summary (following this section), or use an extra sheet of paper if necessary.

Employer Name Position Title/Duties Skills Date Employed
From
Employer Address To
Supervisor's Name: Telephone: Reason for leaving
 

Employer Name Position Title/Duties Skills Date Employed
From
Employer Address To
Supervisor's Name: Telephone: Reason for leaving