SMP Live

Online Job Application

* Required Fields

* Date of Application:

* First Name:

* Middle Name:

* Last Name:

* E-Mail Address:

* Have you ever worked under another name?

Yes No

If YES, what name?

Permanent Address:

* Street:

* City:

* State:

* Zip:

* Home Telephone:

Alternate Telephone:

Additional Contact Information:

* Position(s) Applying For:
(1)

(2)

(3)

Full Time (35+hrs) Part Time (20-34.9 hrs) Temporary Seasonal

Other - Please Describe:

* Please list the days/hours you prefer and are available to work:
(All the below fields are required, if you are not available to work any of the below days please enter NA)

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
A.M.
P.M.

* Can you work? (check all that apply)

Days Nights/Evenings Weekends Holidays Overtime
Split Shift Other - Please Describe:


* Are you age 18 or older?	Yes No
If NO, can you furnish a work permit?	Yes No

* Are you age 21 or older?	Yes No

* Have you ever been CONVICTED of a felony?	Yes No
If YES, please explain:

* Are you LEGALLY ALLOWED to work in the U.S.?	Yes No
If hired, Federal Law requires documentation verifying your identity and legal authorization to work in the U.S.




EMPLOYMENT HISTORY Please list your most RECENT employment FIRST - DO NOT TYPE "SEE RESUME"

1. * COMPANY:
* May we contact as a reference? Yes No

* Street/City/State/Zip:

* Phone: Fax:

Supervisor's Name: Supervisor's Job Title:

* Your Position:

* Start Date: * End Date:

* Primary Duties:

Were you ever disciplined, warned, or counseled about job performance, conduct, absenteeism, tardiness or policy violations?
Yes No If YES, please explain:

* Reason For Leaving:
Resigned Laid Off Discharged
Other - please explain:

Starting Salary: Ending Salary:

2. COMPANY:
May we contact as a reference? Yes No

Street/City/State/Zip:

Phone: Fax:

Supervisor's Name: Supervisor's Job Title:

Your Position:

Start Date: End Date:

Primary Duties:

Were you ever disciplined, warned, or counseled about job performance, conduct, absenteeism, tardiness or policy violations?
Yes No If YES, please explain:

* Reason For Leaving:
Resigned Laid Off Discharged
Other - please explain:

Starting Salary: Ending Salary:

3. COMPANY:
May we contact as a reference? Yes No

Street/City/State/Zip:

Phone: Fax:

Supervisor's Name: Supervisor's Job Title:

Your Position:

Start Date: End Date:

Primary Duties:

Were you ever disciplined, warned, or counseled about job performance, conduct, absenteeism, tardiness or policy violations?
Yes No If YES, please explain:

* Reason For Leaving:
Resigned Laid Off Discharged
Other - please explain:

Starting Salary: Ending Salary:

*Gaps in employment of (4) four weeks or more:*
From:	To:	Brief Explanations of Reason:

* Experience / Skills Please check any skill/experience you possess and indicate the number of years:
Skill	Yrs	Skill	Yrs
Computer		Groundskeeping
Painting/ Carpentry		Warehouse Work
Electrical		Seamstress/ Tailor
Mechanical		Valid Driver's License
Other:		Valid CDL Class A / B / C
Other:		Other:

* Education
* Education	Name/Location	Major/Course	Graduated	Type of Degree

HIGH SCHOOL:			Yes No
Last Year Completed:	9 10 11 12

COLLEGE:			Yes No
Last Year Completed:	1 2 3 4

GRAD SCHOOL:			Yes No
Last Year Completed:	1 2 3 4

OTHER:			Yes No
Last Year Completed:	1 2 3 4

List any other schooling or training, including training received in the armed forces, which may relate to the type of job you are seeking. Please include any job-related certificates or licenses that you hold or any other job-related equipment that you operate.

List any professional, trade, business or civic associations (you may exclude memberships which would reveal gender, race, religion, national origin, age, disability, or other protected status) or list any additional information you would like us to know.

* List 3 Business or Education References: That are not related to you.
* 1. Name:	* Title:	* Phone:	* Yrs Known:
* 2. Name:	*