Hawkins Homes Employee Application

Last Name*

First Name*

M.I.*

DOB*

Street Address*

Apartment/Unit #

City*

State*

Zip*

Home Phone*

Cell Phone

Email Address*

Date Available*

Desired Salary*

Position Applied for*

Are you a citizen of the United States?*
YESNO
If no, are you authorized to work in the U.S.?
YESNO
Have you ever worked for this company?*
YESNO
If so, when?

Have you ever had a neck or back injury?*
YESNO
If so, explain

Have you ever been convicted of a felony?*
YESNO
If so, explain

Education

High School*

Address*

From*

To*

Did you graduate*
YESNO
Degree*

References

Full Name*

Relationship*

Company*

Phone*

Address*

Previous Employment

Company*

Phone*

Address*

Supervisor*

Job Title*

Starting Salary*

Ending Salary*

Responsibilities*

From*

To*

Reason for Leaving*

May we contact your previous supervisor for a reference?*
YESNO

Military Service

Branch

From

To

Rank at discharge

Type of discharge

If other than honorable, explain

I certify that my answers are true and complete to the best of my knowledge.
I Accept

If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.
I Accept

As a condition of my employment, I agree to cooperate with a drug screening, and agree that I may be tested in the future and terminated
upon any positive testing results.
I Accept