General Information
Name: Last, First Middle
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Desired Position
 Desired Location
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Street Address
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Desired Salary
 Date Available For Work
City
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Please check all that apply:
Full Time (32-40 Hours)
Home Phone
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Age
Arer you at least 18 years old? Yes No
Arer you at least 16 years old? Yes No
Fax
 E-Mail Address
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Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Please indicate the hours you are available to work during both day and evening. Note: Should availability change, it is your responsibility to notify your supervisor.
Have you ever filed an application with this company before? If hired, can you supply proof that you are legally permitted to work in the USA?
Yes No
(Supporting documentation will be required prior to the commencement of employment)
Referral Source:
Work Experience

Please list your work experience for the last five years, beginning with your current position. If you are not presently employed, please list your most recent
position along with a brief description of your activities while unemployed. Do not leave any gaps in your employment history. If you need more space, please
attach additional pages.

May we contact your current employer? If no, at what point may we contact him/her?

Employer
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Starting Position
 Starting Salary
Street Address
Ending Position
 Ending Salary
City
 State
 Zip
Duties
Employer's Phone Number
 Supervisor
Dates of Employment
Start A value is required.
Reasons for Leaving
  
Employer
Starting Position
 Starting Salary
Street Address
Ending Position
 Ending Salary
City
 State
 Zip
Duties
Employer's Phone Number
 Supervisor
Dates of Employment
Start
Reasons for Leaving
  
Employer
Starting Position
 Starting Salary
Street Address
Ending Position
 Ending Salary
City
 State
 Zip
Duties
Employer's Phone Number
 Supervisor
Dates of Employment
Start
Reasons for Leaving
  
Additional Work History Information
Have you ever been fired or forced to resign from any employment?
Have you ever been convicted of a felony crime or pled Nolo Contendere?
Yes No
If yes, please list details, including date(s) of conviction(s) and jurisdiction(s) of crimes(s). (Convictions may not disqualify applicant.)

Have you ever been convicted of a misdemeanor in the last seven years?
Yes No
If yes, please list details, including date(s) of conviction(s) and jurisdiction(s) of crimes(s). (Convictions may not disqualify applicant.)
Education and Training
Type of School Name of School Address of School
(City, State)		 Select last year completed Major Degree
High School
9 10 11 12
College
1 2 3 4
Other  
Skills and Qualifications

Please list any foreign languages in which you speak and describe your level of proficiency.
Please list any additional job skills you believe would be relevant to the position for which you are applying.
Why are you interested in working for Precision Time?
References
Give 3 (three) references who are not related to you and who are not previous employers.
Name
A value is required.		 Relationship
A value is required.		 Years Known
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Home Phone
A value is required.		 Work Phone
A value is required.		  
Name
 Relationship
 Years Known
Home Phone
 Work Phone
  
Name
 Relationship
 Years Known
Home Phone
 Work Phone