Your First Name: Your Middle Name: Your Last Name:
Street Address: City: State: Zip:
Home Phone: Business or Cell Phone:
Have you ever applied for employment with us? No Yes If Yes, When?:
Have you been convicted of or pleaded guilty to, or pleaded no contest to an act of dishonesty, or breach of trust or moral turpitude, such as misdemeanor petty theft, burglary, fraud, writing bad checks, and other related crimes within the last five years?* No Yes If yes, please explain:
Do you have other special training or skills (additional spoken or written languages, computer software knowledge, machine operation experience, etc):
How did you hear of our organization?
If we're interested, when will you be available to begin work? (Month/Year)
Total Hours Available (per week):
Time Available: until
Position #1 Company Name: City: State: Company Phone: Job Title: Name of Supervisor: Time employed (month/year): until Weekly Pay: Describe Your Work: May we contact this employer?: Yes No If No - Why Not?: Reason for leaving:
Position #2 Company Name: City: State: Company Phone: Job Title: Name of Supervisor: Time employed (month/year): until Weekly Pay: Describe Your Work: May we contact this employer?: Yes No If No - Why Not?: Reason for leaving:
Position #3 Company Name: City: State: Company Phone: Job Title: Name of Supervisor: Time employed (month/year): until Weekly Pay: Describe Your Work: May we contact this employer?: Yes No If No - Why Not?: Reason for leaving:
JT Outfitters sets high standards for our employees and compliance with these standards is a condition of employment. If you are offered a position with JTO, you need to carefully consider what we require of you before you accept. As an employee, you must do everything you can to ensure that our external and internal customers have the most pleasant experience possible, including:
Are you willing and able to comply with all the requirements listed? No Yes If your answer is no, or if you have concerns about being able to comply with any of these requirements, please explain:
JT Outfitters is a smoke free and fragrance free workplace.
Please Initial Below: Please Type Full Name: Date: