21THINGS4STUDENTS

Employment Application

APPLICANT INFORMATION
Last Name

oakes

Street
Address

First

Dat
e
Apartment/Unit
#

sarah

45666 flamingo road

City

Sterling heights

Phone

586-867-5309

State

Date
2/17/2015
Available
Position Applied
cashier
for
Are you a citizen of the United
States?
Have you ever worked for this
company?
Have you ever been convicted of a
felony?

mi

M.I.

ZIP

48310

E-mail
Haras725@gmail.com
Address
Social Security
Desired
758537
No.
Wage:

YES l

NO

If no, are you authorized to work in the

U.S.?

YES l

NO

If so, when?

YES

NO l

If yes,
explain

2/10/2015

$6+ an hour

YES l

EDUCATION (PLEASE LIST MOST RECENT FIRST)

School 1

Holden elementary

Addres
s

69874 dundee

From

0
6

YES l

NO

Grissom middle school

Addres
s

68763 van dyke

From

1
3

YES

NO l

School 3

Sterling heights high school

Addres
s

68963 john r road.

From

1
5

YES

NO

School 2

To

To

To

2013

2015

2019

Did you
graduate?

Did you
graduate?

Did you
graduate?

REFERENCES
Please list three professional references you have known at least 3 years and are not friends or relatives.
Full Name

Holly Haffner

Relationshi
p

Company

Grissom middle school

Phone

Address

69753 flute avenue

Full Name

Jimmy Kimmel

797-765-4697

Relationshi
p
Phone

Band teacher

Company

The jimmy kimmel show

Address

68735 hollywood blvd

Full Name

Darth vador

Relationshi
p

Company

Star wars inc.

Phone

Address

3338 space lane

neighbor

687-jim-kimm

teacher

568-875-5687

NO

PREVIOUS EMPLOYMENT
Company

Cactus jacks

Phone

Address

7696 utica road

Superviso
r

Job Title
waitress
Responsibilities
buss tables,
wait on people,
serve, clean

Starting
Salary

To
august
15
Reason for Leaving
3=201
3
May we contact your previous supervisor for a
reference?
From|
JUNE 20
2013

586 739-6964
Norman hendrecks
Ending
Salary

$5.50

$8.75

It was only a summer job

YES

NO

Company

Dairy bar

Phone

Address

57986 icecream drive

Superviso
r

Job Title

cashier

Starting
Salary

248-798-8006
Carmen smit
Ending
Salary

$4.25

$7.75

Responsibilities
Reason for Leaving:
summer job for
extra money, and
they are only open
from that time
May we contact your previous supervisor for a
reference?
From
may 12
2015

To
septembe
r 3 2015

YES

NO

Company

Apple inc.

Phone

Address

68976 computer road

Superviso
r

Job Title

Cashier. Stocker

Starting
Salary

798-369-8967
Steve jobs
Ending
Salary

$7.50

$9.42

Responsibilities
From

To

Reason for Leaving

May we contact your previous supervisor for a

reference?

YES

NO

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.
Signature

Date