application - Cal Farley's Boys Ranch and Girlstown, U.S.A.

EMPLOYMENT RECORDThis section must be completed, even if you are attaching a resume. Begin with your present or most recentemployment. Include self-employment, summer or part-time jobs, & military assignments for the PAST 15 YEARS.Attach an additional sheet if necessary.Employer:_________________________________________Address:__________________________________________City, State, Zip:_____________________________________Phone:____________________________________________Your job title:_______________________________________Supervisor:________________________________________Did you receive any written discipline? Yes NoExplain:___________________________________________Did you voluntarily resign? Yes No N/ADid you give the required notice? Yes No N/ASpecific Reason for Leaving: __________________________Are you eligible for rehire? Yes No UnknownEmployer:_________________________________________Address:__________________________________________City, State, Zip:_____________________________________Phone:____________________________________________Your job title:_______________________________________Supervisor:________________________________________Did you receive any written discipline? Yes NoExplain:___________________________________________Did you voluntarily resign? Yes No N/ADid you give the required notice? Yes No N/ASpecific Reason for Leaving: __________________________Are you eligible for rehire? Yes No UnknownEmployer:_________________________________________Address:__________________________________________City, State, Zip:_____________________________________Phone:____________________________________________Your job title:_______________________________________Supervisor:________________________________________Did you receive any written discipline? Yes NoExplain:___________________________________________Did you voluntarily resign? Yes No N/ADid you give the required notice? Yes No N/ASpecific Reason for Leaving: __________________________Are you eligible for rehire? Yes No UnknownEmployer:_________________________________________Address:__________________________________________City, State, Zip:_____________________________________Phone:____________________________________________Your job title:_______________________________________Supervisor:________________________________________Did you receive any written discipline? Yes NoExplain:___________________________________________Did you voluntarily resign? Yes No N/ADid you give the required notice? Yes No N/ASpecific Reason for Leaving: __________________________Are you eligible for rehire? Yes No UnknownDate Employed:From (mm/yr):_______To (mm/yr):_________Exempt EmployeeHourly EmployeeFinal or current salary:$__________________(Do not leave blank.)Date Employed:From (mm/yr):_______To (mm/yr):_________Exempt EmployeeHourly EmployeeFinal or current salary:$__________________(Do not leave blank.)Date Employed:From (mm/yr):_______To (mm/yr):_________Exempt EmployeeHourly EmployeeFinal or current salary:$__________________(Do not leave blank.)Date Employed:From (mm/yr):_______To (mm/yr):_________Exempt EmployeeHourly EmployeeFinal or current salary:$__________________(Do not leave blank.)Summary of WorkPerformed:Summary of WorkPerformed:Summary of WorkPerformed:Summary of WorkPerformed: