Employment

First Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone:
Email:
Have you ever applied to Comlax before?
Yes   No
Do you have any relatives currently employed
by Comlax?
Yes   No
If Yes,
please list:
Position Desired:
Min Salary Desired:
Available Start Date:
Work Week:
I am over 17
years of age?
Prefered Work Schedule
Day of Week Times I Can Work
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
   
Work Experience
Please list your previous experience beginning with your most recent postion.
Employer 1:
Address:
City:
State:
Zip:
Phone:
Supervisor:
Starting Postion:
Ending Postion:
Duties:
Start Date:
End Date:
Reason For leaving:
Employer 2:
Address:
City:
State:
Zip:
Phone:
Supervisor:
Starting Postion:
Ending Postion:
Duties:
Start Date:
End Date:
Reason For leaving:
   
References
Please list two references not related to you.
Reference 1:
Address:
City:
State:
Zip:
Phone:
Job Title:
How Long Acquantied:
Reference 2:
Address:
City:
State:
Zip:
Phone:
Job Title:
How Long Acquantied:
   
Education and Training
High School
School
City/State
Years
Degree?
Course of Study
College
School
City/State
Years
Degree?
Course of Study

Other Training
School
City/State
Years
Degree?
Course of Study
 
   
General
Have you ever been dismissed or forced to resign from any position?
Yes   No

If yes, please explain

 Have you ever been convicted of a felony crime or theft-related misdemeanor in the last 5 years?
Yes   No

If yes, please explain
If hired, can you provide verification of your legal right to work in the US?
Yes   No
Comlax is an equal opportunity employer, and does not discriminate against any applicant because of  race, color, nationality, religion, sex, age, or disability. Submitting an application for employment does not constitute, guarantee, or imply your employment with our company. All applications will be reviewed.
Please check to indicate you have read and understand this disclaimer.