Countryside RV & Trailer Sales

Name: Last: First: MI:
Street Address:
City: State: Zip:
Telephone:

Position Applied For:
How did you hear of this opening:
When can you start: 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Desired Wage:
Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? Yes No

Are you looking for full time employment? Yes No
If no, what hours are you available?
Are you willing to work swing shift? Yes No
Are you willing to work graveyard? Yes No
Have you ever been convicted of a felony? Yes No
If yes, please full describe the circumstances:

In addition to your work history, are there any other skills, qualifications, or experience we should consider:

Education: School Name and Location, Year, Major, Degree
High School:
College:
College:
Other:

Employment History: (Start with most recent employer)

Company Name:
Address:
Telephone:
Date Started: Starting Wage: Starting Position:
Date Ended: Ending Wage: Ending Position:
Name of Supervisor: May we contact? Yes No
Responsibilities:
Reason for leaving:

Company Name:
Address:
Telephone:
Date Started: Starting Wage: Starting Position:
Date Ended: Ending Wage: Ending Position:
Name of Supervisor: May we contact? Yes No
Responsibilities:
Reason for leaving:

Company Name:
Address:
Telephone:
Date Started: Starting Wage: Starting Position:
Date Ended: Ending Wage: Ending Position:
Name of Supervisor: May we contact? Yes No
Responsibilities:
Reason for leaving: