Employment Application

Name *
Name
Address *
Address
Phone *
Phone
If employed and under 18 years of age, can you furnish a work permit? *
Have you filed an application with TLCAD in the past? *
Are you currently employed? *
If Yes, List their name and contact info
Are you prevented from lawfully becoming employed in this country because of visa or immigration status? (Proof of citizenship or immigration status will be required upon employment.) *
On what date would you be available for work? *
On what date would you be available for work?
When are you available to work? (select all that apply) *
Have you been convicted of a felony within the last 7 years?* (Conviction will not necessarily disqualify applicant from employment.) *
Do you have any family members, friends, or other contacts currently incarcerated in a California Department of Corrections & Rehabilitation institution? (Does not necessarily disqualify applicant from employment.) *
REFERENCES
Give name, email address and telephone numbers of three references who are not related to you and are not previous employers.
Reference 1 Name *
Reference 1 Name
Reference 1 Phone *
Reference 1 Phone
Reference 2 Name *
Reference 2 Name
Reference 2 Phone *
Reference 2 Phone
Reference 3 Name *
Reference 3 Name
Reference 3 Phone *
Reference 3 Phone
EXPERIENCE
Start with your present or last job. Include military service assignments and volunteer activities. (You may exclude organization names that would reveal sex, race, religion, national origin, age, ancestry, disability or other protected status.)
Summarize special skills and qualifications acquired from employment experience or education.