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Pre-Employment Questionnaire
An Equal Opportunity Employer
Carl’s Furniture City employment practices are implemented without regard
to race, color, national origin, gender, religious beliefs, age, disability,
sexual orientation, citizenship status, military status or any other basis
protected by federal, state or local fair employment practices.
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Personal Information
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First Name
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Last Name
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Telephone Number
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Email Address
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Present Street Address
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Permanent Street Address
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Are you 18 years or older?
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Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
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Employment Desired
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Position
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Location
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Date Available
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Salary Desired
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Are you employed now?
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If so may we inquire of your present employer?
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Have you ever applied to this company before?
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Where?
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When?
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Referred by:
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Education
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| Grammar School |
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Name and location of school
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Years attended
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Subjects Studied
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Graduated?
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High School |
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Name and location of school
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Years attended
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Subjects Studied
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Graduated?
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College |
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Name and location of school
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Years attended
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Subjects Studied
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Graduated?
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Trade, Business or Correspondance School |
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Name and location of school
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Years attended
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Subjects Studied
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Graduated?
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General
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Subjects of special study or research work?
Special Skills
Activities (Civic, Athletic, etc.)
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Former Employers
(list below last three employers, starting with the most recent first).
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| Employer 1 |
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Start Date (month/year)
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End Date (month/year)
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Employer Name
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Employer Address
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Position
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Salary
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Reason for leaving
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Employer 2 |
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Start Date (month/year)
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End Date (month/year)
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Employer Name
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Employer Address
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Position
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Salary
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Reason for leaving
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Employer 3 |
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Start Date (month/year)
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End Date (month/year)
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Employer Name
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Employer Address
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Position
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Salary
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Reason for leaving
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Upload resume
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