Practice Application

Carleton Middle School

APPLICATION FOR EMPLOYMENT

Please complete pages 1-4; page 5 is optional. Date 5/23/17
Name Gajewski Cameron David Gajewski
Last First Middle Maiden

Present Address 28093 Wagner Warren Michigan 48093

Number/Street City State Zip

Home Phone (586) 944-7703 Cell Phone (586) 944-7703

Email 826615@student.wcskids.net Social Security No.(use only last 4 digits) XXX-XX-

1223

If under 18, please list age 14 Days/hours available to work

No Preference Thursday 4:00-8:00

Position applied for (1) Cashier Monday 4:00-8:00 Friday N/A

Tuesday N/A Saturday N/A

and salary desired (2) Minimum Wage
Wednesday 4:00-8:00 Sunday 1:00-5:00

How many hours can you work weekly? Can you work nights? No Yes

Employment desired FULL-TIME ONLY PART-TIME ONLY FULL- OR PART-TIME TEMPORARY

When are you available for work? Weekdays and Sunday

TYPE OF SCHOOL NAME OF SCHOOL LOCATION NUMBER OF MAJOR &

(High School, College, (Complete mailing address) YEARS DEGREE
Business or Trade COMPLETED OBTAINED
School, etc.)
High School Cousino 13, Hoover 0 N/A

HAVE YOU EVER BEEN CONVICTED OF A CRIME? No Yes

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s)
was/were committed, sentence(s) imposed, and type(s) of rehabilitation. An affirmative answer to this question will
not necessarily preclude employment; however a false answer will preclude employment.
 APPLICATION FOR EMPLOYMENT
Please list three references other than relatives.

Name Bernard Kassab

Position Student

Company Carleton Middle School

Address 1234 Street st

Telephone (111)-111-1112

Name Agron Gojcaj

Position Student

Company Carleton Middle School

Address 1246 Street rd

Telephone (586) 586-5865

Name Tuyen Duddles

Position Teacher

Company Warren Consolidated Schools

Address 90747 Road av

Telephone (939) 678-1234

An application form sometimes makes it difficult for an individual to adequately summarize a complete background.
Use the space below to summarize any additional information necessary to describe your full qualifications for the
specific position for which you are applying.

I took advanced classes at Butcher Educational Center. Also I worked in a small lawn care service, employed by as
friend, where I learned about having a good work ethic.
 APPLICATION FOR EMPLOYMENT
Work Experience
Please list your work experience (including any military experience) beginning with your most recently held job. If
you were self-employed, give firm name. Attach additional sheets if necessary.

Name of employer

Address Name of last Employment

supervisor dates Pay or salary

City, State, Zip Code From Start

Phone number To Final

Your last job

title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at
this company.

Name of employer

Address Name of last Employment

supervisor dates Pay or salary

City, State, Zip Code From Start

Phone number To Final

Your last job

title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at
this company. Small lawn care, watched siblings, and renovated rooms.

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at
this company.

May we contact your present employer? Yes No

Did you complete this application yourself? Yes No
If not, list name of person completing the application:

Signature of Applicant: Cameron Gajewski Date

5/24/17