Personal Information

Full Name *

Date of Birth *

Phone *

Address

Street Address

City

State

Country

Postal code

If you are hired, can you provide proof that you are legally able to work in the United States? *

Yes

No

How did you hear about us?

Have you ever been convicted of a criminal offense? *

Yes

No

If yes, please state the nature, date, and locations of the offense(s):

List any relatives or friends employed by Chiefs:

Application

Desired Position: *

Desired Salary: *

Are you able to work overtime if necessary? *

Yes

No

Are you at least 18 years old? *

Yes

No

If not, can you provide a work permit?

Yes

No

When are you available to begin working? *

Do you write, speak or understand any language other than English? *

Yes

No

If yes, which language(s)?

What office machines can you operate? *

What special skills, knowledge, or individual capabilities do you have which especially prepare you for the position for which you are applying? *

Education

High School

Name of High School or Trade School you attended:

City/State of High School or Trade School:

# of high school or trade school years completed:

Did you graduate this school?

Yes

No

What type of diploma or certification did you receive?

College or University

Name of College or University you attended:

City/State of College or University:

# of college or university years completed:

Did you graduate this college or university?

Yes

No

What type of degree or diploma did you receive?

Employment History

List all employers for the past 7 years, starting with your present or most recent employer.

Employer Name 1:

Employer Phone 1:

Employer Address 1:

Positions Held 1:

Job Duties 1:

Salary 1:

Hours/Days Worked 1:

Supervisor Name 1:

Current Employer? 1:

Yes

No

May we contact this employer? 1:

Yes

No

Dates Employed 1:

Reason for Leaving 1:

Employer Name 2:

Employer Phone 2:

Employer Address 2:

Positions Held 2:

Job Duties 2:

Salary 2:

Hours/Days Worked 2:

Supervisor Name 2:

Current Employer 2?:

Yes

No

May we contact this employer 2?:

Yes

No

Dates Employed 2:

Reason for leaving 2:

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