APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

Full Name (Last, First, Middle):*

Date of Application:*

Present Address:*

Apt. Number:*

City, State & Zip:*

Cell Phone:*

Home/Other Phone:

Email Address:*

In case of an emergency notify:

Emergency Phone:

Emergency Address:

Relationship:

List any other names or social security numbers that you have used in the past:

Social Security Number (Optional):

Are you eligible to work in the United States?*

Yes

No

Have you ever been employed by China Star?

Yes

No

If YES, dates of employment & reason for leaving:

Do you have a valid driver’s license?*

Yes

No

If YES, State of issuance and license #:

Are you fluent in any languages other than English?

Yes

No

If YES, please list

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses?

Yes

No

If YES, please explain:

EDUCATION

School Level

High School / GED

Name & Location of School Major # of Years Attended? Did you Graduate?

College

Name & Location of School Major # of Years Attended? Did you Graduate?

Trade/Other School

Name & Location of School Major # of Years Attended? Did you Graduate?

SKILLS/CREDENTIALS:

Please list any other skills, licenses or certifications that are job-related

REFERENCES:

(Only include individuals familiar with your work ability – do not include relatives)

table1

Name

Contact Phone

Name of Business/Address

Years Known

table2

Name

Contact Phone

Name of Business/Address

Years Known

EXPERIENCE:

(list last three employers beginning with your current or most recent employer)

table1

Most Recent Employer:*

Address:*

Telephone Number:*

Position/Duties:*

Hours per Week:*

Dates Employed:*

Salary/Pay Rate:*

Supervisor’s Name:*

May we contact?*

Reasons for Leaving:*

table2

Employer Name:

Address:

Telephone Number:

Position/Duties:

Hours per Week:

Dates Employed:

Salary/Pay Rate:

Supervisor’s Name:

May we contact?

Reasons for Leaving:

table3

Employer Name:

Address:

Telephone Number:

Position/Duties:

Hours per Week:

Dates Employed:

Salary/Pay Rate:

Supervisor’s Name:

May we contact?

Reasons for Leaving:

PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION

I certify that the answers and information given on this application are true and complete to my knowledge. I authorize the company and/or its agents, including consumer reporting bureaus, to investigate all statements contained in this application, as may be necessary in arriving at an employment decision (including, but limited to, criminal history and motor vehicle driving records). I release the company and/or its agents from any liability which might arise from such an investigation.

I understand that this application is NOT a contract of employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) will result in termination. I understand that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that employees of China Star serve at-will, and the employment relationship may be terminated at any time by either party, for any or no reason, other than a reason prohibited by law. I also understand that the use of illegal drugs or alcohol on the job is prohibited during employment. In the event that I am employed, I agree to abide by all policies and procedures of this company. If employed, I understand that I will be required to furnish proof of eligibility to work in the United States.