test - Blood Bank of Alaska

Job Application (1)

Position(s) Applied For:*
How Did You Learn About Us?*
- Advertisement
- Employment Agency
- Friend
- Relative
- Walk-in
- Other
Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Mobile Phone*
Are You Over The Age Of 18 Years?*
- Yes
- No
(If no, you may be required to provide authorization to work.)
Have You Filed An Application With Us Before?*
- Yes
- No
Have You Ever Been Employed With Us Before?*
- Yes
- No
Are You Currently Employed?*
- Yes
- No
May We Contact Your Present Employer?*
- Yes
- No
Are You Legally Eligible For Employment In The United States?*
- Yes
- No
(Proof of identity and eligibility will be required upon employment.)
On What Date Would You Be Available For Work?*
MM slash DD slash YYYY
Are You Available To Work:*
- Sunday
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
Can You Travel If Job Requires It?*
- Yes
- No
Have You Been Convicted Of A Felony Within The Last 7 Years?*
- Yes
- No
(Conviction will not necessarily disqualify an applicant from employment.)
Education
Do not write “See Resume” in lieu of completing the entire application for employment.
High School Name and Location*
Years Completed*
Diploma/Degree*
- Yes
- No
Describe Course of Study*
Undergraduate College / University Name and Location*
Years Completed*
Diploma/Degree*
- Yes
- No
Describe Course of Study*
Describe any specialized training, apprenticeship, skills and extracurricular activities:*
Describe any honors you have received:*
State any additional information you feel may be helpful to us in considering your application:*
List professional, trade, business or civic activities and offices held.*
You may exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, disability or other protected status.
References
Verify ALL information is correct. It is the applicant’s responsibility to provide accurate and current reference information.
Reference 1
Reference Name*
Reference Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Reference 2
Reference Name*
Reference Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Reference 3
Reference Name*
Reference Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Have you ever had any job-related training in the United States military?*
- Yes
- No
Employment Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status. Do not state “See Resume” in lieu of completing this section.
Employer 1
Employer*
Employed From:*
MM slash DD slash YYYY
Employed Until:*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Starting Rate/Salary*
Final Rate/Salary*
Job Title*
Supervisor*
Work Performed*
Reason for Leaving*
Employer 2
Employer*
Employed From:*
MM slash DD slash YYYY
Employed Until:*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Starting Rate/Salary*
Final Rate/Salary*
Job Title*
Supervisor*
Work Performed*
Reason for Leaving*
Employer 3
Employer*
Employed From:*
MM slash DD slash YYYY
Employed Until:*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Starting Rate/Salary*
Final Rate/Salary*
Job Title*
Supervisor*
Work Performed*
Reason for Leaving*
Special Skills and Qualifications
Summarize job-related skills and qualifications acquired from employment or other experience:*
Applicant’s Statement

I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days or the duration of the recruitment for which this application for employment is designated. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I understand that any application for employment that is submitted outside of a regular recruitment will be designated as unsolicited.

I hereby acknowledge that any employment relationship with this Company is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of the Company.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.
Signature of Applicant:*
Use your mouse or finger to draw your signature above

Job Application (1)

Education

References

Reference 1

Reference 2

Reference 3

Employment Experience

Employer 1

Employer 2

Employer 3

Special Skills and Qualifications

Applicant’s Statement