Worksheet for compiling information likely to be requested on a job application

 

General information

Name

 

 

Complete mailing address including street, city, state and zip code

 

 

Home phone or message number including area code

 

Work phone including area code

 

Cell phone including area code

 

Education

High School

Name

 

Address including street, city, state and zip code

 

 

Years of attendance

 

Date of graduation or GED earned

 

 

College

Name

 

Address including street, city, state and zip code

 

 

 

Years attended

 

Degree or certificate earned

 

Grade point average

 

Technical and/or business school

Name

 

Address including street, city, state and zip code

 

 

Years attended

 

Degree or certificate earned

 

Grade point average

 

 

Special job-related skills, training, current professional certifications and licenses, volunteer work relevant to jobs you are likely to seek and other accomplishments.

Listing these on an application will make you stand out from other applicants. List any equipment and/or tools that you are able to use and any licenses you have. Also make sure to list any ability you have to speak and/or write other languages, if it is relevant to the job for which you are applying.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What type of work are you looking for?  Part-time, Full-time, Shift or Temporary

 

Are there any specific work times that you know would not work for you?  If so, you may want to note those.

 

Date your available for work.  If you must give your current employer two weeks notice, write “two weeks notice”

 

 

Information about specific skills or qualifications

 

Office work

The following information will likely be required if you are applying for positions requiring typing ability or computer skills.

 

Typing speed/Words Per Minute (WPM)

 

List computer programs you are familiar with.

 

Transcription skills.

 

Other computer skills such as internet, desktop publishing, etc.

 

 

 

Positions requiring a driver’s license

 

Years of driving experience

 

Types of vehicles driven

 

Driver’s licenses number

 

State issues

 

Expiration date

 

Endorsements (if applicable)

 

Commercial driver’s license number

 

State issued

 

Expiration date

 

Endorsements

 

Were you involved in any accidents in the last three years. 

 

If yes, how many?

 

Brief description of each accident.  Indicate if any deaths or personal injury were involved.

 

Date of accident

 

Description

 

Have you ever had a driver’s license suspended, withdrawn, revoked or denied?

 

If yes, explain.

 

 

Do you have access to an insured vehicle?

 

Any convictions for traffic violations in the last three years?

 

If yes, describe violations other than parking tickets.

 

Date of violation

Description

 

 

 

Arrest/conviction record

Make sure to be truthful because not reporting can result in job termination if information that was not reported is later discovered.  The information you report is generally considered only if the position applied for has particular security requirements or if the employer feels there is a bona fide occupational qualification inherent in the position which requires this information prior to hiring.

 

Have you been convicted of a felony in the last 7 years?  Conviction will not necessarily disqualify an applicant from employment.

If yes, explain.

 

 

 

 

 

Do you have any criminal charges pending other than MINOR traffic violations?  Pending charges are not an automatic bar to employment. 

If yes, explain.

 

 

 

References.  Character and professional.

Be prepared to provide names, current business addresses, and current phone numbers of up to four reference, professional or work related references, if possible, who can speak positively about you.  Avoid using relatives.  Clergy members, teachers, counselors, friends who are in business, and leaders of organizations in the community usually make good references. Other people to use for references include staff at places you have volunteered, teachers, and individuals you may help out such as neighbors.  Be sure to ask for their permission before listing them and verify where they can be reached. Up to four references, professional or work related references if possible.  

 

Reference number 1

Name

 

Occupation

 

Address including street, city, state and zip code

 

Phone number

 

Reference number 2

Name

 

Occupation

 

Address including street, city, state and zip code

 

Reference number 3

Name

 

Occupation

 

Address including street, city, state and zip code

 

 

Reference number 4

Name

 

Occupation

 

Address including street, city, state and zip code

 

Employment History

Begin with most recent job.  List employer's name, current address and telephone number, supervisor, job title, dates of employment, salary, and reason for leaving. Describe your job duties clearly. Use action verbs. Concentrate on skills that will interest the employer. The job description can provide clues about important skills. Explain any gaps in your work history.

 

Employer’s name

 

Date employed

 

Address

 

Phone

 

Title of your position

 

Highest wage

 

Starting wage

 

Hours worked per week

 

Name of supervisor

 

Number of employees you surpervised

 

Primary duties

 

 

 

 

Reason for leaving or considering change

 

 

 

 

 

Next Employer’s name

 

Date employed

 

Address

 

Phone

 

Title of your position

 

Highest wage

 

Starting wage

 

Hours worked per week

 

Name of supervisor

 

Number of employees you surpervised

 

Primary duties

 

 

 

 

Reason for leaving or considering change

 

 

 

Next Employer’s name

 

Date employed

 

Address

 

Phone

 

Title of your position

 

Highest wage

 

Starting wage

 

Hours worked per week

 

Name of supervisor

 

Number of employees you surpervised

 

Primary duties

 

 

 

 

Reason for leaving or considering change

 

 

 

 

Additional Information that may be requested

 

Previous address

 

Reasons for gaps of 90 days or more in your work history other than school should be accounted for in another section or in your cover letter.  Practice writing your responses here:

 

 

 

 

 

 

 

 

 

Facts regarding military service.  Bring your discharge papers.  You might be asked if you’re a veteran of any war.  This is Affirmative Action program information, not discrimination.

 

Entry and discharge dates

Type of discharge

Branch

Occupational specialization

Special training received and dates

Last rank

 

 

 

 

 

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