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1. Name (Last, First, Initial)

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2. Address

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3. Phone Number

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4. Employment Desired

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5. Wage Desired

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6. Weekly Hours Desired

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7. Can you work weekends?

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8. The date you can start

Date
Time

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9. Any physical heavy lifting limitations?

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10. Are you prepared to work in adverse weather conditions?

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11. Please indicate when you are available to work

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12. Do you have any special scheduling limitations? (Child Care, Extracurriculars, etc.)

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13. Do you have a valid Ohio drivers' license?

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14. Ohio Drivers License Number; include Expiration Date and Type

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15. Can you drive a standard shift truck?

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16. Work History

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17. Are you currently employeed?

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18. May we contact your current employer?

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19. Do you have the legal right to work in the U.S.?

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20. Have you ever been convicted of a crime

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21. If yes, please explain

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22. Hobbies and Interests

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23. List foreign languages spoken and fluent level

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24. Education

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25. Describe special training you may have received that would aid you in the position you are applying for

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26. List any equipment or machinery in which you've had experience operating

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27. In your own words, define Customer Service

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28. Why are you the best candidate for our team?

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