Employment Application

Date

Location*

Position Applying For*

Name

First Middle Last

Address

Street Address Address Line 2 City State ZIP Code

Phone

Email

Current Employment Status

Available start date if hired

Days Available to work

Hours available to work:

Are you authorized to work in the United States?

Yes
No

Do you have reliable transportation?

Yes
No

Have you ever been convicted of a crime?

Yes
No

If yes, was this a felony or misdemeanor

Felony
Misdemeanor

Have you ever been terminated from a job? If yes, please explain

Education

High School Name

Major

Did you graduate?

College Name

Major

Did you graduate?

Trade School Name

Major

Did you graduate?

Work History

Please list your work experience in the past five years, beginning with most recent employer.

Name of Employer

Employed From*

Employed To*

Address

Street Address Address Line 2 City State ZIP Code

Phone

Supervisor

Rate of pay

Job Duties (be specific)

Presently Employed

Yes
No

Reason for leaving

May we contact the above employer?

Yes
No

Name of Employer

Employed From*

Employed To*

Address

Street Address Address Line 2 City State ZIP Code

Phone

Supervisor

Rate of pay

Job Duties (be specific)

Presently Employed

Yes
No

Reason for leaving

May we contact the above employer?

Yes
No

Name of Employer

Employed To*

Employed From*

Address

Street Address Address Line 2 City State ZIP Code

Phone

Supervisor

Rate of pay

Job Duties (be specific)

Presently Employed

Yes
No

Reason for leaving

May we contact the above employer?

Yes
No

Describe any other skills and/or qualifications that you have that relate to the position you are applying for

Skills

Computer Skills

If other, please list skills here

Equipment

List two (2) Business References (cannot be relatives):

Name

First Last

Company

Years known

Phone

Name

First Last

Company

Years known

Phone

DMA Sales, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, DMA Sales, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

It is the policy of DMA Sales, LLC to require all associates to receive wage payments via electronic deposit. Electronic deposit includes checking, savings, and any other source where payment can be received. DMA Sales, LLC does not have any exceptions and at no time will a paper check be issued to any associate.

I hereby certify that the information provided is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, immediate termination. I hereby authorize any of the persons or organizations listed in my application to give all information concerning my previous employment, education, or any other information they might have, personal or otherwise, regarding any of the subjects covered by this application and release all such parties from all liability that may result from furnishing such information to you. I authorize DMA Sales, LLC to request and receive such information. In consideration for my employment and my being considered for employment.

*

I understand that DMA Sales LLC requires a pre employment drug screen and criminal background check

Attach Resume*

Drop files here or

Applicant’s Signature

Date

Comments

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