Monroe

ounty

nterprises
EMPLOYMENT APPLICATION

Provide all information requested by printing in ink or keying. Use the tab key to move through the document.

GENERAL INFORMATION
Name (Last)

(First)

Address (Mailing Address)

(City)

(Middle
Initial)
(Stat
e)

E-mail Address

(Zip)

Home Telephone

() -
Cell Phone

() -

POSITION
Will Accept:
Part-Time

Position or Type of Employment Desired

Have you ever been employed at the Monroe County Enterprises before?
Yes
No
Are you able to perform the essential functions of the job you are applying
for, with or without reasonable accommodation?
Yes
No

Full-Time

Date Available:

Salary Desired

$___________ / monthly

EDUCATION AND TRAINING

School or
Institution

Name and Address of School

Major/Study

Beginning
& Ending
Year

Degree

Mary Persons High School

High School

College Name
College Address

College City &

State
Special Abilities and Skills (3 tasks from CIS)

________________ Pathway

Extracurricular Activities (at least 2 areas of

Present Community and Professional

Affiliations (at least 2)

interest/hobby)

2016-2020
2020-2024

BA

Professional Certificates or Licenses Held (Yes

or No)

Languages Read, Written or Spoken Fluently Other Than English

REFERENCES
List below names and addresses of persons who are qualified to answer questions concerning your fitness for the
position(s) you seek other than those listed in your credential file. (3 classmates from THIS class. Get a sheet of
paper and Go to the L Drive folder REFERENCES jot down the information and come back to this
document and type it in.)

Name

Position

Address

AN EQUAL OPPORTUNITY EMPLOYER

Telephone

WORK EXPERIENCEMost recent first, include voluntary work and military experience
Employer
Address
Job Title
Specific Duties (Maximum 350 characters)
lifting heavy objects
assembling products
budget reports
taking pictures
filing
washing/cleaning vehicles
typing
copying
running errands

recording

assisting the director/boss

customer service
driving/delivering
answering phone

data entry

Telephone Number () -
Number Employees Supervised 2
operating heavy machinery

faxing

cleaning

supervising 1 / 2
stocking
organizing
Reason For Leaving Graduated College

inventory control

cutting/washing hair

Hours Per Week

15-20
Last Salary
$____/hour

handling various reports

repairing equipment

ordering/buying supplies

counseling

From (Month/Year)
October/2022
To (Month/Year)
March/2024

Supervisor
S. Dorsey

May We Contact This Employer?

No

Yes

I certify the information contained in this application is true, correct, and complete. I understand that, if
employed, false statements reported on this application may be considered sufficient cause for dismissal.
You will enter an electronic signature. Click in the gray box beside Signature of Applicant select any
script or cursive style font type your first and last name (capitalize the first letter of each).

Signature of Applicant:

Date:

AN EQUAL OPPORTUNITY EMPLOYER