Employment Application
  Date:  
Personal Information
Full Name:        
    Last         First Middle Maiden
Social Security Number                   Date of Birth:  
Current Address  
  Number Street City State Zip Code
Previous Address  
  Number Street City State Zip Code
Are you a U.S. citizen?   Yes   No  
     
If not, are you legally able to work in the U.S.?   Yes   No  
Telephone Number   Referred by    
                             
Employment Desired
Position applied for:       Desired salary      
   
    FT   PT   Either   Holiday/Temp  
   
Hours available:  
  Any/All   Wednesday   Wireless Connection is a retail store with standard retail store hours.  Therefore, flexibility is important to coordinate with our scheduling needs.
  Sunday   Thursday  
  Monday   Friday  
  Tuesday   Saturday  
     
Applied to Wireless Connection before?     Yes   No  
When?   Where?      
                             
References: Name Telephone Years known Relationship
           
         
         
Employment History
Please list most recent first              
Start Date   Employer   Position  
End Date   Address   Telephone  
Salary   Reason for Leaving   Supervisor Name  
May we contact?   Duties Performed  
 
Start Date   Employer   Position  
End Date   Address   Telephone  
Salary   Reason for Leaving   Supervisor Name  
May we contact?   Duties Performed  
 
Start Date   Employer   Position  
End Date   Address   Telephone  
Salary   Reason for Leaving   Supervisor Name  
May we contact?   Duties Performed  
 
Start Date   Employer   Position  
End Date   Address   Telephone  
Salary   Reason for Leaving   Supervisor Name  
May we contact?   Duties Performed  
 
Start Date   Employer   Position  
End Date   Address   Telephone  
Salary   Reason for Leaving   Supervisor Name  
May we contact?   Duties Performed  
Explain any gaps in employment:  
 
 
 
General Information
List any specialized skills or training:  
 
 
 
 
Military Service:                      
Start Date   Branch   Honorable Discharge?  
End Date   Rank   Special honors  
Education:
  Name Location Highest grade completed GPA Major
High School          
College          
Trade School          
Post Graduate          
Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment or to confer any right to remain an employee of Wireless Connection (WCC), or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and the relationship cannot be altered except by a written instrument signed by an officer of the company.  Both the undersigned and WCC may end the employment relationship at any time, without specified notice or reason.  If employed, In understand that WCC may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benenfits. 
The Fair Credit Reporting Act requires us to advise you that, in connection with our routine processing of your employment application, we may request from a consumer reporting agency an investigative consumer report including information as to your character, general reputation, personal characteristics, and mode of living.  Upon written request from you, we will provide you with additional information concerning the nature and scope of any report requested by us.
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.  This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”  
Signature of Applicant: