Bead Inspirations 1544 Park St. Alameda, CA 94501 510-337-1203 www.beadinspirations.com [email protected]

INSTRUCTIONS:     Complete the application form in ink or typed.  Bead Inspirations is an Equal Opportunity-Affirmative Action Employer providing equal employment opportunity to all regardless of sex, race, color, religion, ancestry, national origin, age, marital status, medical condition (cancer related), or physical handicap. 

1.         Title of Position:

 

2.         Your Social Security Number:             -       -           (For Identification Purposes Only)

 

3.             Your Name:   Last                                                  First                                                         Middle

 

4.             Address:                 Number and Street                       City                                    State     Zip

Mailing Address

               

 Physical Address

                       

       

Email Address

 

5.    Telephone Number:  Home: (      )         -               Cell: (      )         -                

 

6.    Can you, after employment, submit verification of your legal right to work in the United States?       
Yes    No

 

7.  As an adult, have you ever been convicted of a misdemeanor or felony offense other than a minor traffic violation?

                Yes    No

If "YES", please give date and nature of the offense below.  (Convictions are evaluated for each position and are not necessarily disqualifying):

8.  Do you have a valid California driver's license?             Yes    Class                      Number                                  No

9.   Indicate the type of position you will accept: 
 Full-time permanent (40 hours per week)

        Part-time permanent position (fewer than 40 hours per week)   

        Extra Help position (hours per week may vary)

 

10.            Do you speak any languages other than English?            Yes            No  If yes, please list: 

 

11.  Skills: Please list relevant skills and abilities.

_______________________________	_______________________________	_______________________________
_______________________________	_______________________________	_______________________________
_______________________________	_______________________________	_______________________________

 

12.   EDUCATION:  Did you graduate from high school?     Yes    No   
If "NO" did you receive a GED?           Yes    No

       If "NO", indicate highest year completed:  1   2   3   4   5   6   7   8   9   10   11   12

Name and Location of High School:
Name and Location of College or University	Major		Semester Units Completed	Quarter Units Completed	Degree Conferred
					Type:         Date:
					Type:         Date:
					Type:         Date:
Business, Correspondence, Trade or Service Schools		Course of Study

 

 

 

13. EXPERIENCE: eginning with most recent job, please fully account for all time, including periods of unemployment, military service, and relevant volunteer experience.  If you were employed under another name, write in the name by which you were known to your employer.  If additional space is needed, attach a sheet of paper. By listing names of prior employers and supervisors, you are consenting, unless otherwise indicated in writing, to Bead Inspirations contacting those persons specifically listed (or persons who are available through the employer if the supervisor listed is no longer employed) for purposes of confirming information relating to your prior employment including but not limited to, providing a reference.

 

Dates of Employment and Salary Received	Job Title(s) and Duties Performed	Employer's Name, Address, Phone and Type of Business
From                              Month      Year To                                 Month      Year Salary:	Job Title:       Hours Per Week:        Supervisor's Name:       Job Duties:       Number of Persons Supervised: