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In Memory
Ray Lemons
December 19, 1936 - June 4, 2008
Employment Application
Personal Information
Name:
Social Security No:
Present Address:
Apt. No.:
City:
State:
Zip:
Permanent Address:
Apt. No.:
City:
State:
Zip:
Are You 18 Years or Older?
Phone Number:
Desired Employment
Position:
Date you can start:
Salary Desired:
Are you employed now?
YES
NO
If so, may we inquire of your present employer?
YES
NO
Ever applied to this company before?
YES
NO
Where?
When?
Ever worked for this company before?
YES
NO
Where?
When?
Reason for leaving:
Name of last supervisor at this company:
Who referred you to this company?
Employment Agency
Newspaper Advertising
Friend
State Employment Office
College Placement Service
Walk In
Other