Employment Application - Milwaukee Country Club

Applicant Information

Last Name

First Name

Middle Initial

Street Address

Apartment/Unit #

City

State

ZIP Code

Email

Phone

Position Applied for

Desired Salary

CDL

Yes

No

If yes, license #

Are you a citizen of the United States?

Yes

No

If no, are you authorized to work in the U.S.?

Yes

No

Have you ever worked for this company?

Yes

No

If yes, when?

Have you ever been convicted of a felony?

Yes

No

If yes, explain

Education

High School

Address

From

To

Did you graduate?

Yes

No

Diploma

College

Address

From

To

Did you graduate?

Degree

Other

Address

From

To

Did you graduate?

Degree

References

Full Name

Relationship

Company

Phone

Full Name

Relationship

Company

Phone

Full Name

Relationship

Company

Phone

Previous Employment

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Previous Employment 2

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Previous Employment 3

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Military Service

Branch

From

To

Rank at Discharge

Type of Discharge

Disclaimer & Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature

Date: