Employment Inquiry

I understand that this in not an Employment Application. This inquiry will, however, be reviewed, and my qualifications considered for possible job openings in the near future. If this company finds my qualifications and employment background match a current opening I will be contacted to complete an Application for Employment.

The information below is needed to complete this review.

Last Name
First Name
Middle Name
Today's Date
Address
City, State, Zip
Phone Number
Position Sought
Desired Wage

Type of Employment Available For:

Seasonal	Temporary	Full Time	Part Time
Hours/Shift Available
Days Available

Employment Experience:

Most recent position
Dates Employed
Wages
Reason for Leaving
Primary Duties
Prior Position
Dates Employed
Wages
Reason for Leaving
Primary Duties

Education:

Check the number of years completed for each of the following:
High School	1	2	3	4
Undergrad College	1	2	3	4
Graduate College	1	2	3	4
Describe course of major concentration
List any professional, technical or other training relative to the type of employment sought:

All individuals considered for employment are evaluated without regard to race, color, religion, gender, national origin, age, marital or veteran status, the presence of a non-job related disability or any other legally protected status. Date Signature