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APPLICATION FOR EMPLOYMENT
GTF-1000
Revision: 4
City of Muskegon Date: 07/31/07
We are an Equal Opportunity Employer. Applicant resume s are accepted without regard to race, religion, color,
sex, age, national origin, veteran status or disabilit y and in accordance with state and federal laws.
===========================================================================================================
PERSONAL INFORMATION
Name
Last First Middle
Present
Address
Street City State Zip
Phone
No.
Are you 18 years or older? Yes No
Licensed Driver? Yes No If yes, Drivers License Number
Describe any U.S. Military Service: (Branch, Rank, Nature and Date
of
Discharge)
Are you presently in the United States armed forces, active or reserve? If so, identify unit and any service obligations.
Have you even been convicted of a crime or are you presently charged with a felony? If so, where and when, and explain
circumstances.
Were you ever denied bond? Yes No If yes, please explain
Do you have limitations that may unable you to perform job tasks? Yes No If yes, please explain
Is there some type of accommodation that would enable you to perform the functions of a job? Yes No
If
yes,
please
explain
EMPLOYMENT DESIRED
Date
you Salary
Position can start desired
Are
you
employed
now?
If so, may we inquire of your present employer?
Have you ever applied to this company before? Yes No
Where? When?
APPLICATION FOR EMPLOYMENT
GTF-1000
Revision: 4
City of Muskegon Date: 07/31/07
Have you ever worked for this company before? Yes No
Where? When?
Are you eligible to work in the U.S. and able to provide proof? Yes No
Do you have any activities, commitments or responsibilities (for example, school, other employment, etc.) that might
interfere with your ability to work full time, including overtime, in the position for which you are applying? If so, explain.
EMPLOYMENT EXPERIENCE In the space below, give a record of each period of employment and/or unemployment.
Start with your current or most recent employment and work backwards to the first. Give the name used on the payroll if
other than the name given on this application. Use additional sheets if necessary.
Employer/Company
Location Phone
Position
Start Date / / Supervisor's
Name
Ending Date / / Last Pay Rate $ per
Reason for leaving
Employer/Company
Location Phone
Position
Start Date / / Supervisor's
Name
Ending Date / / Last Pay Rate $ per
Reason for leaving
Employer/Company
Location Phone
Position
Start Date / / Supervisor's
Name
Ending Date / / Last Pay Rate $ per
Reason for leaving
APPLICATION FOR EMPLOYMENT
GTF-1000
Revision: 4
City of Muskegon Date: 07/31/07
Which
of
your
jobs
did
you
like
best?
Why?
What special skills or knowledge do you have that will aid you in qualifying for employment?
EDUCATION
Do you have a high school diploma or equivalent? Yes No
Name and Location of School Number of Years Attended
Did you graduate? Subjects Studied
College
Trade,
Business
or
Correspondence
School
Subjects of Special Study or Research Work
REFERENCES Give the names of three persons, not related to you, whom you have known at least one year.
Years
Name
Address Business Phone
# Acquainted
In case of emergency notify:
Name
Address Phone
No.
APPLICATION FOR EMPLOYMENT
GTF-1000
Revision: 4
City of Muskegon Date: 07/31/07
READ CAREFULLY AND SIGN BELOW IF YO U AGREE TO THESE TERMS OF EMPLOYMENT
By signing my name below, I understand that GoodTemps Temporary Staffing is an at-will employer and nothing
contained in this application or in the interview process is intended to create an employment contract between
GoodTemps Temporary Staffing and me. Should this application result in my employment, I have the right to terminate
my employment at any time and for any reason and GoodTemps Temporary Staffing retains a similar right. I further
understand that no representative of GoodTemps Temporary Staffing other than the President has any authority to enter
into any agreement with me for any specified period of time or to guarantee some other personnel move or benefit. I
further understand that this entire statement applies to the period prior to and after I may be employed.
Additionally, by signing my name I certify that all information provided by me is correct to the best of my knowledge. I
understand that omissions and misrepresentations may result in the rejection of my application or, if hired, result in
termination.
I agree that the contents of any office, locker or desk or equipment or other GoodTemps Temporary Staffing property I
may use, and any of my own property I bring onto GoodTemps Temporary Staffing's premises (including, without
limitation, cars, packages, and purses), may be inspected by GoodTemps Temporary Staffing at any time, and I waive
any claims against GoodTemps Temporary Staffing or its agents relating to such inspection.
I agree that I will not disclose to anyone or use for my own purposes any of GoodTemps Temporary Staffing's confidential
or proprietary information, either during or after my employment, except at the request and for the benefit of GoodTemps
Temporary Staffing. I agree that information about GoodTemps Temporary Staffing's customers, vendors, sources of
supply, pricing, costs, and other financial information, products, services, methods of operation, marketing, engineering
methods, production, and the like is confidential and proprietary information that belongs to GoodTemps Temporary
Staffing. If my employment with GoodTemps Temporary Staffing ends, I will not retain any copies or summaries of any
such information but will promptly return all such information to GoodTemps Temporary Staffing. I also agree that I will
disclose and assign to GoodTemps Temporary Staffing any invention, design or process that I conceive or develop while
employed by GoodTemps Temporary Staffing relating to GoodTemps Temporary Staffing's business or any product or
service offered or being developed by GoodTemps Temporary Staffing, and that all such inventions, designs or processes
belong to GoodTemps Temporary Staffing.
I agree to submit to physical examinations and medical tests (including blood, urine or other testing) permitted by law
before and during my employment, at the request and expense of GoodTemps Temporary Staffing, and I agree to
disclose all information lawfully requested at such examinations about my physical and mental condition and medical
history. I waive any claims against GoodTemps Temporary Staffing or its agents or any testing agency retained by
GoodTemps Temporary Staffing or its agents relating to any such testing, or from lawful if decisions made regarding my
employment or termination of employment based upon the results of such testing or analysis.
I agree that I will not commence any action or lawsuit relating to my employment with GoodTemps Temporary Staffing, or
the termination of my employment, more than 12 months after the termination of my employment, and I agree to waive
any statute of limitations to the contrary. I understand that this means that even if the law would give me the right to wait a
longer time to make a claim, I am waiving that right, and that any claims not brought within 12 months after my
employment ends will be barred.
I agree to the above terms of employment. I agree that if any of the above terms is ever found to be legally unenforceable
as written, such invalidity will not affect the validity of the rest of this agreement, and such term shall be limited to allow its
enforcement as far as legally possible. I agree that no one other than the president of GoodTemps Temporary Staffing, by
a written directive, has any authority to modify the above terms of employment, or to make any exception to them, or to
offer employment on any other terms.
I agree that I will be bound by and will adhere to any other rules and policies issued by GoodTemps Temporary Staffing,
including all rules and policies contained in GoodTemps Temporary Staffing 's employee handbook.
Signature
of
Applicant:
Date: