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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
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?
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
Business, Correspondence, Trade or Service Schools
Course of Study
13. EXPERIENCE: Beginning 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
Hours Per Week: Supervisor's Name:
Number of Persons Supervised:
14. May we contact your present employer? Yes No
15. List memberships in professional organizations that you feel would enhance your application. You may exclude, if you wish,any whose names would indicate the race, religion, age, color, national origin, marital status, gender, sexual orientation orancestry of its members.________________________________________________________________________________________________________________________________________________________________________________________________
16. Professional licenses or certifications:_________________________________________________________________
17. List memberships in professional organizations that you feel would enhance your application. You may exclude, if you wish, any whose names would indicate the race, religion, age, color, national origin, marital status, gender, sexual orientation of its members.________________________________________________________________________________________________________________________________________________________________________________________________
18. Employment References: Give names and addresses of at least two people, not relatives, who have knowledge of your skills, experience, and ability. Previous supervisors are preferred.
19. Person who we may notify in case of emergency:
Please attach any additional information to your application which you feel will help us in our evaluation of your qualifications.
Before you return your application, check your application to make sure that it is correct and complete. Thank you for your interest in employment with Bead Inspirations!
READ THIS STATEMENT BEFORE SIGNING -I certify that the answers given herein are true and complete to the best of my knowledge. I also authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that an investigative report may be prepared whereby information is obtained through public records and personal interview with various individuals. I understand that submission of an application does not guarantee employment.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written documentation or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.
I understand that this application is considered current for three months. If I wish to be considered for employment after this period I must fill out and submit a new application. In the event of employment, I understand that false, omitted, or misleading information given by my application or interview(s) may result in discharge, when discovered. I understand, also, that I am required to abide by all rules and regulations of the Employer.
BY SIGNING BELOW I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD, AND AGREE TO THE ABOVE STATEMENTS.
How did you find out about this job? _______________________________________