Employment Application
Personal Information
First Name
Middle Name
Last Name
Street Address
City
State
Zip
Phone
Minimum Age Under 16   16   19 
   
Emergency Contact
Name
Address
Phone
   
Desired Employment
Location
Position
Employment Type Full   Part   Summer
Desired Salary
Days Available
M T W T F S S
Date You Can Start
Referred By:
Have you ever
been employed by
DJ's Dugout?
Yes
No
   
Education
School Name Type
Location Field of Study
Start Date End Date Gradutation Date
 
School Name Type
Location Field of Study
Start Date End Date Gradutation Date
 
School Name Type
Location Field of Study
Start Date End Date Gradutation Date
 
School Name Type
Location Field of Study
Start Date End Date Gradutation Date
 
 
Employment History
Employer Title
Address Duties
Phone Salary
May We Contact Reason For Leaving
Yes
No
Start Date End Date
 
Employer Title
Address Duties
Phone Salary
May We Contact Reason For Leaving
Yes
No
Start Date End Date
 
Employer Title
Address Duties
Phone Salary
May We Contact Reason For Leaving
Yes
No
Start Date End Date
 
Employer Title
Address Duties
Phone Salary
May We Contact Reason For Leaving
Yes
No
Start Date End Date
 
 
Additional Areas of Expertise
Areas of specialized study,
research or additional
experience
List the foreign languages
you speak fluently
Have you ever served in
the military ?
If so, describe
   
Physical Record
Do you have any physical
disabilities that prevent
you from performing the
work for which you are applying?
If so, describe
Have you ever been injured?
If so, describe
 

By submitting this form you acknowledge that you have read, and agree, to the following terms:
I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.