Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Social Security Number
*
Are you legally eligible to work in the United States?
*
Yes
No
Are you over the age of 18?
*
Yes
No
If under the age of 18, can you provide working papers?
*
Yes
No
Have you ever applied for a job with Golden Dawn?
*
Yes
No
Have you ever worked for Golden Dawn before?
*
Yes
No
What position are you applying for?
*
What is your expected salary/wage?
*
For what other positions would you like to be considered?
*
What type of employment are you seeking?
*
Full-time
Part-time
Temporary
Please specify the days and hours that you are available to work.
*
On what date would you be available to start work?
*
Do you meet the age requirements for the position for which you are applying?
*
Yes
No
List any special skills or abilities related to the job applied for:
*
Describe your greatest accomplishment from any previous position that you have held:
*
What is the highest level of education that you have completed?
*
High School (9)
High School (10)
High School (11)
High School (12)
College / Undergraduate
Graduate
Please list the schools that you have attended and number of years attended, beginning with high school:
*
Name and Address of Employer:
*
Dates of employment:
*
Describe the work you did:
*
Salary:
*
Reason for leaving:
*
Supervisor's name and phone number:
*
May we contact them?
*
Yes
No
Name and Address of Employer:
*
Dates of employment:
*
Describe the work you did:
*
Salary:
*
Reason for leaving:
*
Supervisor's name and phone number:
*
May we contact them?
*
Yes
No
Name and Address of Employer:
Dates of employment:
Describe the work you did:
Salary:
Reason for leaving:
Supervisor's name and phone number:
May we contact them?
Yes
No
Reference name, occupation and phone number:
Reference name, occupation and phone number:
Reference name, occupation and phone number:
Have you served in the United States Armed Forces?
*
Yes
No
If yes, which branch of service?
If yes, total months of active duty:
If yes, rank of induction, highest rank achieved:
Specialized military experience:
Have you ever been convicted of a felony or a misdemeanor other than a minor traffic offense?
*
Yes
No
If yes, list date, city, charge and disposition?
(Conviction of a felony or misdemeanor will not automatically disqualify you from consideration for employment.)
AFFIDAVIT: I authorize or instruct Golden Dawn to make whatever inquiries it deems necessary (of any former employer, personal reference, or school official named in this application or referred by a person named in this application) in order to verify any information given in my application and/or determine my qualifications and abilities and I agree to release and hold harmless those entities from any and all liability arising from the release of such information. I understand that such inquiries may include information as to my character, general reputation or personal characteristics. Statements I have made in the application are true and complete. I understand that if, in the judgement of Golden Dawn, I have made any false statements, omissions, concealments, any misrepresentations or have failed to answer any questions fully and accurately, or results of such investigation are not satisfactory, any offer made by Golden Dawn may be withdrawn or my employment with Golden Dawn may be terminated immediately, without any obligation to me other than for payment at the rate agreed upon for services rendered during employment. I agree to conform to the rules and regulations of Golden Dawn, and understand that my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at the option of either Golden Dawn or myself. I further understand that no personal recruiter or interviewer or other representative of Golden Dawn has any authority to enter into an agreement for employment for any specified period of time unless such agreement is in writing and signed by Golden Dawn's designated representative.
*
Date:
*
