Application for Employment
(Pre-Employment Questionnaire)

Please Print  

________	  ____________________	  ____________________	  ______________ 
Date	   Last Name 	   First Name		   Middle 

PRESENT ADDRESS

_______________________________	______________  _____	_________ 
No. & Street				City	       State	        	Zip Code

(____) _______________      (____) ________________     _________________
 Business Phone	                         Home Phone	                                           Social Security Number 

E-mail address:  __________________________________________________
EMPLOYMENT DESIRED       

Position applying for: _______________________________________    Desired Salary: ___________________	 
PERSONAL INFORMATION 
Have you ever applied to or worked for	Arrow Sign Company before?	 Yes    No 
If yes, when?	_______________________________ 

Do you have any friends or relatives working for	Arrow Sign Company……………………….. Yes    No 
If yes, state name(s) and relationship:

________________________________________		_______________ 
Name		Relationship 
________________________________________		_______________ 
Name		Relationship 

How did you hear about Arrow Sign Company? 
 ________________________________________________________________ 
If hired, would you have a reliable means of transportation to and from work? 	  Yes    No 
Are you at least 18 years old? (If under 18, hire is subject to verification that you are of 
minimum legal age.) 	  Yes    No 
If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country? 
	  Yes    No 

Arrow Sign Company Employment Application – Page 2  
Do you possess a valid California Driver License? (If “Yes” fill in information below.) 	  Yes    No

License #_______________________   Class:_____________________   Restrictions:__________________________

Are you able to perform the essential functions of the job for which you are applying, either 
with or without reasonable accommodation?  	  Yes    No

If no, describe the functions that would require accommodation.

____________________________________________________________ 

____________________________________________________________ 

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.) 

EDUCATION, TRAINING and EXPERIENCE

	Name & Location of School	Number of Years	Did you Graduate?	Degree or Diploma	
Grammar School   					
High School					
College					
Trade, Business, Correspondence School					

Arrow Sign Company Employment Application – Page 3
EMPLOYMENT HISTORY
List on page three all present and past employment starting with your most recent employer (last five years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching a resume.   

______________________________	(___) ________ 
Name of Employer 	Telephone No.
______________________________	______________________________ 
Type of Business	Your Supervisor's Name	 
______________________________	_______________	___	_____-____ 
Address & Street	City	 State	 Zip 
Dates of Employment:	________	________	
	From	To		 
____________________________________________________________ 
Your Position and Duties 
____________________________________________________________ 
Reason for Leaving 

______________________________	(___) ________ 
Name of Employer 	Telephone No.
______________________________	______________________________ 
Type of Business	Your Supervisor's Name	 
______________________________	_______________	___	_____-____ 
Address & Street	City	 State	 Zip 
Dates of Employment:	________	________	
____________________________________________________________ 
Your Position and Duties 
____________________________________________________________ 
Reason for Leaving 

REFERENCES
List below three persons not related to you who have knowledge of your work performance within the last three years. 
Note: Attach additional page(s) if necessary. 
	Name	Business	Address and Phone Number	
1.				
2.				
3.				

Arrow Sign Company Employment Application – Page 4 

Please Read Carefully, Initial Each Paragraph and Sign Below 

______	I hereby certify that I have not knowingly withheld any information that might adversely affect my
 Initials	chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

______	I hereby authorize the company to thoroughly investigate my references, work record, education and
 Initials	other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release Arrow Sign Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

______
 Initials	I understand that nothing contained in the application, or conveyed during any interview which maybe granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or Arrow Sign Company, and that no promises or representations contrary to the foregoing are binding on Arrow Sign Company unless made in writing and signed by me and the company’s designated representative.
______
  Initials	Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by Arrow Sign Company I am entitled to copies of any such public records obtained by Arrow Sign Company unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.
	
	   I waive receipt of a copy of any public record described in the paragraph above

____/____/____	_________________________________________
                  Date			Applicant’s Signature

Revised January 8. 2018