SERVICES



Personal Information

Your Name:  
Date:  
Social Security #:  
Address:  
City:  
State  
Zip:
Phone:  
   

Are you lawfully prevented from becoming employed in this country because of a visa or immagration status?

Yes No




Employment Desired

Position  
Salary desired:  
Date you can start:  
Are you employed now?  
   

If yes, may we inquire of your present employer?

Yes No

   

Have you even applied to
A Courteous Communications Corp. before?

Yes No

If Yes, when?  
and what position?  
Referred by:  



Education

  Name & Location of School # of Years Attended and
did you Graduate?
Subjects Studied
High School Yes No
College Yes No
Other Yes No



General

Subjects of specific study or reseach:  
Special Skills:  
Activities (civic, athletic, etc. - please DO NOT list organizations whose name indicates the race, creed, sex, marital status, color, or nation of origin of its members)  
U.S. Military or Naval Service:  
Rank:  
Present membership in National Guard or Reserves:  



Former Employers

From To Name & Address of Employeer Salary Position Reason for Leaving

Which of these jobs did you like best and why?





References


Please list three persons you have know at least one year who are not related to you.
Name Address Business Years Acquainted



In Case of Emergency

Please notify:
Name Address Phone



"I certify that all the information submitted by me on this application is true and complete. I understand that if any false information, omissions, or misrepresentations are discovered, my application my be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations. I agree that my employment and compensation can be terminated, with or without case, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed with or without case, and with or without noticed, at any time by the company. I understand that no company representative, other than its president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing."

Date Your Name




Please review your information and submit your application by clicking on the Submit button below.



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