Employment Application
Paradigm Corporation is an Equal opportunity Employer |
Last Name
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First Name
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Middle Name
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Address
City| State |Zip
Phone
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Are there other names under which your employment or educational records references and other information may be verified?
Yes No
Other Name |
If Hired, can you submit verification of your legal right to work in the US?
Yes No |
If you are under 18 years of age, can you provide proof of eligibility to work?
Yes No |
Have you previously applied for employment with this company
Yes No |
How did you hear about the company?
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| Some positions require that an employee drive a personal vehicle in the course of assigned duties. |
Do you have a drivers license?
Yes No
Are you insured?
Yes No
If not are you insurable?
Yes No |
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Have you ever been Convicted of any crime other than a minor traffic violation?
Yes No If yes please explain. A previous conviction is not an automatic bar to employment.
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Type Of Employment Desired |
Preferred Position
Salary Expected
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Date Available
Work Schedule
Full Time Part Time
Hours
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Employment History
Please list your employment history for the last then years or the last four employers starting with your present or most recent employment and noting any periods you were not employed in the the section marked "Additional Information" |
Employer Name
Address
City| State |Zip
Position
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From date
To Date
Start salary
End Salary
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Supervisor
Title
Phone
If present employer, can we contact?
Yes No |
Describe your principle duties and responsibilities
Reason for leaving
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Employer Name
Address
City| State |Zip
Position
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From date
To Date
Start salary
End Salary
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Supervisor
Title
Phone
If present employer, can we contact?
Yes No |
Describe your principle duties and responsibilities
Reason for leaving
|
Employer Name
Address
City| State |Zip
Position
|
From date
To Date
Start salary
End Salary
|
Supervisor
Title
Phone
If present employer, can we contact?
Yes No |
Describe your principle duties and responsibilities
Reason for leaving
|
Employer Name
Address
City| State |Zip
Position
|
From date
To Date
Start salary
End Salary
|
Supervisor
Title
Phone
If present employer, can we contact?
Yes No |
Describe your principle duties and responsibilities
Reason for leaving
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Education |
High school name
city state
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did you graduate
Yes No
if GED, date received
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| Higher/Continuing Education |
College or Other Schools Attended
City | State
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Number of Years Attended
Did You Graduate
Yes No |
Diploma Degree Certificate
Course of Study
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College or Other Schools Attended
City | State
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Number of Years Attended
Did You Graduate
Yes No |
Diploma Degree Certificate
Course of Study
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College or Other Schools Attended
City | State
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Number of Years Attended
Did You Graduate
Yes No |
Diploma Degree Certificate
Course of Study
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Professional Licensure, Registry, Certification |
Type of License/Register or Certification
Issuing State or Organization
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Number
Expiration Date
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Type of License/Register or Certification
Issuing State or Organization
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Number
Expiration Date
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Type of License/Register or Certification
Issuing State or Organization
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Number
Expiration Date
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Special Skills
Summarize any training and skills that would be applicable to your employment; eg., word processing, spreadsheet, medical terminology, foreign languages, etc....
Additional Information
Please indicate any additional information that you would be applicable; eg., internships, membership in professional organizations, additional relevant employment and explanation of any gaps in employment. Exclude any information which would denote your race, sex, age, marital status, nation of origin, religious or political affiliations.
References
Please list three business/professional individuals who have knowledge of your occupational skills and background |
Name
Phone
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Occupation
Relationship
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Name
Phone
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Occupation
Relationship
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Name
Phone
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Occupation
Relationship
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Post a text only version of your resume.
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