Job Application

Personal Information

Position applied for:

Today’s date:

Date Available to start work:

Last Name:

First Name:

Middle Initial:

Social Security Number:

E-mail address:

Home phone:

Address (number, street, apartment number):

City, State and Zip:

Message/Work phone:

CAN YOU, AFTER EMPLOYMENT OFFER, SUBMIT VERIFICATION OF YOUR LEGAL RIGHT TO WORK IN THE UNITED STATES?

_ Yes _ No (In accordance with the immigration Reform and Control Act of 1986, any offer of employment is conditioned upon satisfactory proof of applicant’s identity and legal ability to work in the United States.)

Are you at least eighteen years of age?

_ Yes _ No

How did you find out about this employment opportunity?

_ Better Business Bureau Website _Newspaper _ Radio/TV _ State RECRUIT System

_ Employment Website _ Agency Bulletin _ Other ______________________

Are you a veteran of the Armed Forces? _ Yes _ No If yes, what branch? _______________________________________

Dates served: Start                                         End

Have you ever been convicted of a felony, for any violation(s) of law, including moving traffic violations ? _ Yes _ No If YES, please provide the following: Description of Offense, Date of Charge, Date of Conviction, and County, City, State of Conviction.

Job Interest

Preferred job status:
 _ Full-time _ Part-time

Are you willing and able to travel?
 _ Yes_ No

Do you have any relatives that work here? _ Yes _ No

Are you employed any where now? _ Yes _ No

Were you previously employed by Wisconsin BBB? _ Yes _ No
From:                   To:              Position:

Hours of Availability:

Day

Sun

Mon

Tues

Wed

Thu

Fri

Sat

Start

End

Education

a. Check highest grade completed _1 _2 _3 _4 _5 _6 _7 _8 _9 _10 _11 _12      Year Completed______________

b. If you did not complete high school, do you have a high school equivalency diploma? _ Yes _ No
Date Received______________

c. Check number of years of post high school education _1 _2 _3 _4 _5 _6 _7

Type of
School

Name and Location

Years Completed

Major Course
of Study

Graduated
(Yes or No)

Degree

High
School

College/
University

Graduate

School

Technical/
Business

Name:

Position Applied For:

Employment History

Starting with the most recent, describe ALL paid, military and applicable voluntary experience. Highlight your knowledge, skills and abilities which best demonstrate your qualifications for this position. You may list significantly different jobs within the same organization separately.

Employer:

Position:

Address:

Type of Business

City: State: Zip:

Duties:

Telephone Number:

Supervisor

Title

Reason for leaving:

Dates Employed– Start:                 End:   

Salary– Start:                             End:

May we contact this employer? _ Yes _ No

Employer:

Position:

Address:

Type of Business

City: State: Zip:

Duties:

Telephone Number:

Supervisor

Title

Reason for leaving:

Dates Employed– Start:                 End:

Salary– Start:                         End:

May we contact this employer? _ Yes _ No

Employer:

Position:

Address:

Type of Business

City: State: Zip:

Duties:

Telephone Number:

Supervisor

Title

Reason for leaving:

Dates Employed– Start:                     End:

Salary– Start:                                     End:

May we contact this employer? _ Yes_ No

Employer:

Position:

Address:

Type of Business

City: State: Zip:

Duties:

Telephone Number:

Supervisor

Title

Reason for leaving:

Dates Employed– Start:                     End:

Salary– Start:                                     End:

May we contact this employer? _ Yes _ No

Employer:

Position:

Address:

Type of Business

City: State: Zip:

Duties:

Telephone Number:

Supervisor

Title

Reason for leaving:

Dates Employed– Start:                     End:

Salary– Start:                             End:

May we contact this employer? _ Yes _ No

Name:

Position Applied For:

Job-Related Skills or Experience

Please list any job related professional, trade, business or civic activities, organizations, and associations in which you participated, or of which you are a member (You may omit those that indicate race, color, religion, political affiliations, national origin, ancestry, disability, marital status, sex, or age) that would qualify you for the position for which you are applying:

References

Please provide at least two (3) professional references who are not related to you.

1. Name:

Occupation:

Relationship:

Telephone:

2. Name:

Occupation:

Relationship:

Telephone:

3. Name:

Occupation

Relationship:

Telephone:

FOR OFFICE USE ONLY

Department:

Position applied for:

Interviewed by:

Interview date:

Time:

Second Interviewed by:

Second Interview date:

Time: