SAINT NICHOLAS SCHOOL 3511 Linkwood Drive, Houston, Texas 77025 | Phone (713) 791-9977 | Fax (713) 791-9594 APPLICATION FOR EMPLOYMENT Pre-employment Questionnaire | An Equal Opportunity Employer Date: Personal Information Name(Last Name First Name) Social Security No. Present Address Apt. No. City State Zip Permanent Address Apt. No. City State Zip Are you 18 years or older? YesNo Phone #1 Phone #2 Desired Employment Position Date you can start Salary desired Are you employed now? YesNo If so, may we inquire of your present employer? YesNo Ever applied to this company before? YesNo Where? When? Ever worked for this company before? YesNo Where? When? Reason for leaving Name of last supervisor at this company Who referred you to this company? Employment AgencyNewspaper AdvertisingFriendLinkedinState employment officeCollege placement serviceWalk inOther Education School Level Name and location of school No. of years attended Did you gradurate? Subjects studied Grammar School High School College Trade, business or correspondence school Subjects of special study of research work Special training Special skills/hobbies/interests Former employers List below the last three employers, starting with the most recent: No friends Name of present or last employer Address Suite No. City State Zip Starting date Leaving date Job title Weekly starting salary Weekly final salary May we contact your supervisor? YesNo Name of supervisor Title Phone Fax Description of work Reason for leaving Name of present or last employer Address Suite No. City State Zip Starting date Leaving date Job title Weekly starting salary Weekly final salary May we contact your supervisor? YesNo Name of supervisor Title Phone Fax Description of work Reason for leaving Name of present or last employer Address Suite No. City State Zip Starting date Leaving date Job title Weekly starting salary Weekly final salary May we contact your supervisor? YesNo Name of supervisor Title Phone Fax Description of work Reason for leaving Former employers Below, give the names of three principals or supervisors you have worked for. Please No personal references No Name Adress Telephone/Fax Years acquainted/relationship 1 2 3 Military Service Record Branch of service Discharge date: Rank: Misdemeanors / Felonies Have you been convicted of a felony or misdemeanor?YesNo If yes, explain(Will not necessarily exclude you from consideration) Authorization I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information converning my previous employment and any pertinent information they may have, personal or otherwise, and please saint nicholas schools("Company") from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period time or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. Date: Please write us a brief note explaining why you would be an asset to our school, and why this would be a good move for you professionally.
