Federal Envelope Company

The company provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or veteran status in accordance with applicable laws.

General Information

First Name:	Middle Name:
Last Name:
Address:

City, State, Zip:
Home Phone:	Business Phone:
Social Security #
email address:
Are you eighteen years of age or older?		Yes
Are you legally eligible for employment in the United States? (Proof of employment authorization will be required if hired.)		Yes
Have you ever been convicted of a felony? (Record of conviction does not necessarily disqualify applicant from employment consideration but will be considered in relation to specific job requirements.)		Yes

Have you ever applied for employment with us?		Yes
If yes, Month/Year, Location:

Type of employment you are seeking:		Full Time Part Time
If part-time, list day(s) and hour(s) available.


Position Desired:

Pay Expected:
When will you be available to begin work?

Work Experience

Most Recent Employer
From (Month/Year):			To:
Starting Rate/Salary:			Ending:
Employer:
Address:

City, State, Zip:
Supervisor's Name:
Phone:

Your Duties (Summarize):


Specific Reason For Leaving:


Previous Employer
From (Month/Year):			To:
Starting Rate/Salary:			Ending:
Employer:
Address:

City, State, Zip:
Supervisor's Name:
Phone:

Your Duties (Summarize):


Specific Reason For Leaving:

Education and Training

		Check Last Year Completed
High School:		9th 10th 11th 12th
	Specific Degree/Certificate

Business or Trade School:		1yr 2yrs 3yrs 4yrs None
	Specific Degree/Certificate

College or University:		1yr 2yrs 3yrs 4yrs None
	Specific Degree/Certificate

Graduate Study:		1yr 2yrs 3yrs 4yrs None
	Specific Degree/Certificate

References
List those persons willing to provide personal and / or professional references. (Do not include relatives.)

Primary Reference
Name:
Occupation:
Address:

City, State, Zip:
Phone:

Secondary Reference
Name:
Occupation:
Address:

City, State, Zip:
Phone: