Application - Advanced Automation LLC

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Employment Application

"*" indicates required fields

Date*

Name*

First Middle Last

Home Phone

Mobile Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Are you a citizen of the United States?*

Yes

No

If no, are you authorized to work in the United States?*

Yes

No

If so, when:*

Emergency Contact Name*

Phone*

Relation*

Address*

Street Address Address Line 2 City State ZIP Code

EMPLOYMENT DESIRED

Position Applying For*

Date Available*

Desired Wage

Ever applied to this company before?*

Have you ever been convicted of a Felony?*

Yes

No

If yes, please explain:*

EDUCATION

Highest Level of Education*

No GED, No High School

High School Diploma

GED

Some College

College Degree

High School

Address

Years Attended

Did you graduate?

Yes

No

College

Address

Years Attended

Did you graduate?

Yes

No

Degree

Other

Address

Years Attended

Did you graduate?

Yes

No

Degree

MILITARY SERVICE

Military Branch

From:

To:

Rank at discharge:

Type of discharge:

If other than honorable, please explain:

PREVIOUS EMPLOYMENT

Name of Company / Address

Supervisor Name

Phone

Job Title

Starting Wage

Ending Wage

Responsibilities Included

Start and end date

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Name of Company / Address

Supervisor Name

Phone

Job Title

Starting Wage

Ending Wage

Responsibilities Included

Start and end date

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Name of Company / Address

Supervisor Name

Phone

Job Title

Starting Wage

Ending Wage

Responsibilities Included

Start and end date

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Which of these jobs did you like the best?

How did you hear about Advanced Automation?*

Current Employee

Career Fair

Newspaper Ad

Radio/TV Ad

Search Engine

Social Media/Digital Ad

Other

REFERENCES

Reference #1*

First Last

Relationship*

Company*

Phone*

Reference #2*

First Last

Relationship*

Company*

Phone*

Reference #3*

First Last

Relationship*

Company*

Phone*

Upload your Cover Letter (optional) & Resume*

Drop files here or

Accepted file types: jpg, pdf, Max. file size: 10 MB.

Additional Info (Optional)

Certify*

I Certify

I CERTIFY THAT MY ANSWERS ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. IF THIS APPLICATION LEADS TO EMPLOYMENT, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION IN MY APPLICATION OR INTERVIEW MAY RESULT IN MY RELEASE.

ADVANCED AUTOMATION IS AN EQUAL OPPORTUNITY EMPLOYER