ALLIANCE
5729 Whittier Blvd.,
Los Angeles CA 90022
323-838-9999 Ph
323-887-2627 Fax

Employment Application Form

Personal Data:

First Name:	Last Name:
Birthdate:	Age:
City Address:
Provincial Address:
Sex:Male Female	Status:Single Married Widow
Religion:
Citizenship:	Nationality:
Height:	Weight:labs
Contact No.:	E-mail address:
Hobbies:
Language or Dialect Spoken or Written:

Family Background

Spouse's Surname:	First Name:	Occupation:
Father's Surname:	First Name:	Occupation:
Mother's Surname:	First Name:	Occupation:
Dependent's Name:	Relationship:	Occupation:

Educatoinal Background/Attainment

ELEMENTARY
Name of School:	School Year:
HIGH SCHOOL
Name of School:	Degree Received:	School Year:
VOCATIONAL
Name of School:	Degree Received:	School Year:
COLLEGE
Name of School:	Degree Received:	School Year:
Course/Bachelor of:	Special skills:

Employment Record

Name of Company:	Address of the Company:
Position:	From - To:
Name of Company:	Address of the Company:
Position:	From - To:
Name of Company:	Address of the Company:
Position:	From - To:

Character Reference

(At least 3 Persons)

Name:	Address of the Person:
Position:	Contact No.:
Name:	Address of the Person:
Position:	Contact No.:
Name:	Address of the Person:
Position:	Contact No.:

Employment Agreement

Please read the following statement completely before agreeing to the APPLICANT'S STATEMENT.

I understand that this employer does not unlawfully discriminate in employment and no questions on this application are used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

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.

I certify that I have read, fully understand and accept all terms of the forgoing Applicant Statement.

Agree Disagree

Comments and questions: