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Employment Application
Name *
Email *
Phone *
Current Mailing Address *
Date of Birth *
Age
Who referred you to Calico?
POSITION
What position are you applying for? *
Are you interested in: *
Part-Time
Full-Time
Date available:
Salary acceptable per hour
Salary acceptable per month
Have you ever worked for Calico? *
Yes
No
Have you ever been convicted for anything other than a minor traffic violation?
Yes
No
EDUCATION
Highest grade competed:
ACTIVITIES
Class organization, scholastic honors, and other school activities (please include organizations which indicate race, credd, color or national origin):
Hobbies and recreational interests:
EMPLOYMENT HISTORY
Name and address of most recent employer:
Employment dates (Ex: 12/14-2/16):
Supervisor name & title:
Phone number:
Your position:
Pay Rate (Starting & Final)
Reason for Leaving:
May we contact this employer?
Yes
No
Select the dates you are available to work:
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
EMERGENCY CONTACT INFORMATION
Name
Address
Phone
APPLICANT SIGNATURE
*
By typing your name you are agreeing to electronically sign this document
Date *
