Thank you for your interest in Gray Flex Systems.  Please complete the employment application below.

GENERAL INFORMATION:

Last Name:

First Name:

Middle Name:

Current Address:

City:

State:

Phone#:

Are you 18 years old?

Are you prevented from lawfully becoming employed in this country because of VISA or Immigration?

Postion applying for:

Start Date:

Desired Salary:

Are you employed now?

If so, may we inquire of your present employer?

Ever applied to this company before?

WHERE?

WHEN?

Referred by:

EDUCATION:

Grammar Sch:
Name/Location:

Years Attended:

Graduate?

Subjects Studied:

High Sch:
Name/Location:

Years Attended:

Graduate?

Subjects Studied:

College:
Name/Location:

Years Attended:

Graduate?

Subjects Studied:

Trade Sch/Other:
Name/Location:

Years Attended:

Graduate?

Subjects Studied:

List Special Skills:

Are you in the Armed Services:

Pay Grade:

Have you ever been convicted of a felony or served time in a correctional inst.?

REFERENCES: (List below the last three employers – start with the last employer first)

Employer 1: Name

Salary:

Position:

Reason for Leaving:

Job Description:

Employer 2: Name

Salary:

Position:

Reason for Leaving:

Job Description:

Employer 3: Name

Salary:

Position:

Reason for Leaving:

Job Description:

List below two persons not related to you, whom you have known for at least one year.

Name 1:

Phone#:

Business:

Name 2:

Phone#:

Business:

I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information omissions or misrepresentations are discovered my application may be rejected, and if I am employed my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company’s rules and regulations. I agree my employment and compensation can be terminated with or without cause or notice at any time at either at my or the company’s option. I also understand and agree that the terms and conditions of my employment may be changed with or without notice at any time by the company. I understand that no company representative other than its president and then only when in writing and signed by the president has any authority to enter into any agreement contrary to the foregoing.

DATE:

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