Employment Application Cape Cod Express - Office Application Application for Employment (Office Applicants) Contact InformationApplication Date* MM slash DD slash YYYY First Name* Middle Initial Last Name* Street Address* Apartment/Unit # City* State* Zip Code* Telephone #*Email Address* Previous Addresses (if less than 3 years at current address)Previous Address 1Previous Address 2Previous Address 3Position & AvailabilityPosition / Shift Applied For* Employment Type Part Time Full Time Seasonal How did you hear about Cape Cod Express? Were you referred? Yes No If yes, by whom? Are you currently employed? Yes No If no, date of last employment GeneralHave you ever worked for this company before? Yes No If yes, position held (previous employment with this company) Dates employed (From / To) - previous employment with this company Reason for leaving - previous employment with this companyHave you ever worked for this company under another name? Yes No Name you were using when employed Position held (under other name) Dates employed (From / To) - under other name Reason for leaving - under other nameAre you legally authorized to work in the U.S.?* Yes No Have you ever been convicted of a felony?* Yes No If yes, please explain fullyEmployment HistoryCompany 1 - Name* Company 1 - Address Company 1 - City Company 1 - State Company 1 - Zip Code Company 1 - Supervisor Company 1 - Position Held Company 1 - Dates Employed (From / To) Company 1 - ResponsibilitiesCompany 1 - Reason for LeavingCompany 2 - Name Company 2 - Address Company 2 - City Company 2 - State Company 2 - Zip Code Company 2 - Supervisor Company 2 - Position Held Company 2 - Dates Employed (From / To) Company 2 - ResponsibilitiesCompany 2 - Reason for LeavingCompany 3 - Name Company 3 - Address Company 3 - City Company 3 - State Company 3 - Zip Code Company 3 - Supervisor Company 3 - Position Held Company 3 - Dates Employed (From / To) Company 3 - ResponsibilitiesCompany 3 - Reason for LeavingEducationHigh School - Name High School - City / State High School - Attended From High School - Attended To Did you graduate High School? Yes No High School - Degree achieved High School - Highest grade completed College - Name College - City / State College - Attended From College - Attended To Did you graduate College? Yes No College - Degree achieved College - Highest grade completed Other School - Name Other School - City / State Other School - Attended From Other School - Attended To Did you graduate (Other School)? Yes No Other School - Degree / Certificate achieved Experience and QualificationsTyping (WPM)Data Entry (KPH)Customer Service Experience - YearsCustomer Service Experience - MonthsMicrosoft Office Version Microsoft Office - Year Microsoft Office Programs Used Word Excel Access PowerPoint Other qualifications, licenses, certificates, and achievementsAcknowledgment & SignatureTo be read and signed by the applicant:It is agreed and understood that the employer or the employer’s agents may investigate the applicant’s background and obtain information concerning the applicant’s record, and the applicant releases employers and persons named herein from all liability for any damages on account of furnishing such information. This investigation may include an investigative consumer report regarding character, general reputation, personal characteristics, and mode of living. The applicant agrees to furnish such additional information and complete such examinations as may be required to complete the employment file.(MA) An applicant for employment with a sealed record on file with the commissioner of probation may answer “No Record” with respect to inquiries concerning prior arrests, criminal court appearances, or convictions as described in the Massachusetts notice on the original application form.Applicant Acknowledgment* I have read and understand the above statement. Date Signed* MM slash DD slash YYYY Applicant's Signature (type full name)*
