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Employment Application Form

Personal Details

First Name *
Middle Name
Last Name *
Address *
City *
State *
Zip Code *
Telephone *
Social Security Number
Position Applied For *

Additional Details

Available to Work	Full Time Part Time Temporary Full Time + Overtime
How do you find out about the position for which you are applying?	Employee Referral Friend Relative Newspaper Ad Other
If Other, give details
Have you ever worked for Standard Supplies Inc. ?	Yes No
If yes, give date of employment
Are you 18 or older (the minimum working age)?	Yes No
Are you legally permitted to work in this country? (Proof of citizen or immigration status and complete Immigration and Naturalization Services Form 1-9 will be required upon employement)	Yes No
Do you have any physical, mental or medical impalments that would interface with ability to perform the job requirements of the postion for which you are applying?	Yes No
If yes, please explain
How would you describe your ability to speak, read and write English	Good Fair Poor

What languages, other than English, do you speak, read and write.? How would you describe your fluency?
	Good Fair Poor
	Good Fair Poor
	Good Fair Poor

Have you been indicted,arrested or convicted of a criminal offense within the last 7 years?	Yes No
If yes, please explain
Do you have any judgements for debts not paid?	Yes No
If yes, please explain

Education Detail

Type	Name/Location	Course	Yrs. Completed	Degree/Diploma
Elementary
Middle/Jr. High
High-School
College
Technical/Military Training
Other

References (Other than relatives)

Name	Occupation	Year Known	Address	Phone Number

Employement Detail

Please provide us details on your employement experience for the previous ten years. Start with your cuurent or most recent job.

Employment Detail 1

Employer
Phone Number
Address
Position(s)
Supervisor
Starting Wage ($)		Final ($)
Date Employed From		To
Reason for Leaving
Primary Duties/Responsibilities

Employment Detail 2

Employer
Phone Number
Address
Position(s)
Supervisor
Starting Wage ($)		Final ($)
Date Employed From		To
Reason for Leaving
Primary Duties/Responsibilities

Employment Detail 3

Employer
Phone Number
Address
Position(s)
Supervisor
Starting Wage ($)		Final ($)
Date Employed From		To
Reason for Leaving
Primary Duties/Responsibilities

Employment Detail 4

Employer
Phone Number
Address
Position(s)
Supervisor
Starting Wage ($)		Final ($)
Date Employed From		To
Reason for Leaving
Primary Duties/Responsibilities

Employment Detail 5

Employer
Phone Number
Address
Position(s)
Supervisor
Starting Wage ($)		Final ($)
Date Employed From		To
Reason for Leaving
Primary Duties/Responsibilities

Other Detail

Please detail any additional information you feel will help us in considering your abilities to perform the job which you are applying.You may want to include special skills and qualifications acquired from employement or education, non working/volunteer activities hobbies, memberships in professional or trade organizations, and/or business activities. Please include position held,responsibilities and dates for these activities.

	Fields marked with * are required.

Memberships

We are proud to be members of the following organizations.

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Standard Supplies Inc. is pleased to announce the launch of a new division within our Steel Division

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