The Monsen Company - Never Underestimate The Wonders of a Perfect Environment

Application

Personal Information

Mr./Mrs.
First Name*
Middle Name
Last Name*
Email*
Telephone Number*		ex. (201) 555-5555
Are You 18 Years or Older?*		Yes No

Present Address
… Street*
… Apartment Number
… City*
… State
… Zip Code*

Employment Desired
Business Unit
Position of Interest
… Other Position (if not listed)
Date You Can Start
Salary Desired
Are You Employed Now?*		Yes No
… If So, May We Inquire of Your Present Employer?		Yes No
Ever Applied To This Company Before?*		Yes No
… Where?
… When?
Ever Worked For This Company Before?*		Yes No
… Where?
… When?
… Reason For Leaving
… Name of Last Supervisor At This Company
Who Referred You To This Company?

Education

School Level	Name and Location of School	No. of Years Attended?	Did You Graduate?	Subjects Studied
Grammar School			Yes No
High School			Yes No
College			Yes No
Trade, Business, or Correspondence School			Yes No

General

Subjects of Special Study or Research Work
Special Training
Special Skills

Former Employers

List below last three employers, starting with last one first.

Employer # 1		Your present or last employer.

Name of Employer
Address of Employer
Job Title
Starting Date
Leaving Date
Weekly Starting Salary
Weekly Final Salary
May We Contact Your Supervisor?		Yes No
Name of Supervisor
Title of Supervisor
Phone Number of Supervisor
Description of Work
Reason For Leaving

Employer # 2		Your present or last employer.

Name of Employer
Address of Employer
Job Title
Starting Date
Leaving Date
Weekly Starting Salary
Weekly Final Salary
May We Contact Your Supervisor?		Yes No
Name of Supervisor
Title of Supervisor
Phone Number of Supervisor
Description of Work
Reason For Leaving

Employer # 3		Your present or last employer.

Name of Employer
Address of Employer
Job Title
Starting Date
Leaving Date
Weekly Starting Salary
Weekly Final Salary
May We Contact Your Supervisor?		Yes No
Name of Supervisor
Title of Supervisor
Phone Number of Supervisor
Description of Work
Reason For Leaving

References

Give below the names of three persons not related to you, whom you have known at least one year.

	Name	Address	Business	Years Acquainted
1.
2.
3.

Service Record

Branch of Service
… Discharge Date
… Rank
Present Membership In National Guard or Reserves
… Date Obligation Ends

Authorization

"I certify that all of 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, and I agree that my employment in compensation can be terminated, with or without notice, at any time, at either or the company's option. I also understand and agree that the terms and conditions of my employment may be changed with or without cause and with or without notice, at any time by the company. I understand that no company representative, other than its president, and then only in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing."