Pta-logo PTACIT New Employment Application



Personal Information







Employment Information
Can you meet attendance requirements? Can you work overtime?
Can you travel if requested? Have you ever been employed by PTAC?
Do you have valid Identification? Are you authorized for legal employment?
Are you 18 years of age or older? Have you been convicted of a felony crime?



Employment History
Begin with information regarding your most recent employer
Employer 1
Employer Position
Supervisor Name Supervisor Title
Supervisor Phone
Employment Address
Employed From Employed To
Salary Salary Type
Job Summary
Reason for Leaving

Employer 2
Employer Position
Supervisor Name Supervisor Title
Supervisor Phone
Employment Address
Employed From Employed To
Salary Salary Type
Job Summary
Reason for Leaving

Employer 3
Employer Position
Supervisor Name Supervisor Title
Supervisor Phone
Employment Address
Employed From Employed To
Salary Salary Type
Job Summary
Reason for Leaving

Employer 4
Employer Position
Supervisor Name Supervisor Title
Supervisor Phone
Employment Address
Employed From Employed To
Salary Salary Type
Job Summary
Reason for Leaving



Other Skills and Qualifications
(Please summarize any job related training, skills, licenses, etc below)



Education History
Highschool Did you graduate?
Diploma Last year attended?
College Did you graduate?
Diploma Last year attended?
Other Did you graduate?
Diploma Last year attended?



References
Name Relationship Years known?
Phone Email

Name Relationship Years known?
Phone Email

Name Relationship Years known?
Phone Email