Childress Form

First Name*

Middle Name*

Last Name*

Email Address*

Enter Email Confirm Email

Present Address*

Permanent Address*

Are you 18 or older?*

Yes
No

Are you either a U.S. Citizen or an alien authorized to work in the United States?*

Yes
No

Employment Desired*

Full-Time
Part-Time

Position*

Date you can start*

Salary Desired*

Are you currently employeed?*

Yes
No

If so, may we inquire of your present employer?

Yes
No

Have you ever applied to this company before?*

Yes
No

Education

Grammar School

High School

Did you graduate?

Yes
No

Graduation Date

College or University

Did you graduate?

Yes
No

Date Graduated

Trade, Business, or Correspondence School

Subjects of special study or research work

Special Skills

Activities

U.S. Military or Naval Service*

Yes
No

If yes, What was your rank?

Present membership in National Guard or Reserves?*

Yes
No

Previous Employment

*Notice: The Age Discrimination in Employment Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.

Previous Employer 1

Contact Name

Phone Number

Address

Start Date

End Date

Reason For Leaving

Previous Employer 2

Contact Name

Phone

Address

From Date

To Date

Reason For Leaving

Previous Employer 3

Contact Name

Phone

Address

From Date

To Date

Reason for leaving

References

Name

Phone

Years Acquainted

Name

Phone

Years Acquainted

Name

Phone

Years Acquainted

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 refernces listed above to give you and and all information concerning my previous employment and any pertinent information they may have and release all parties from all liability fro any damage that may result from furnishing same to you. I understand and agree that, if hired, my employment is for wages and salary to be determined at any time without prior notice and without cause.*

Yes

Today's Date

Signature*

Childress Commerical Property, Inc.

Education

Previous Employment

*Notice: The Age Discrimination in Employment Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.

References

Follow Us

Archives