Job Application: Project Manager

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Title: Project Manager

Fields marked with an asterisk (*) must be filled out before submitting.

Pre-Employment Questionnaire (An equal opportunity employer)

First & Last Name *
Social Security Number *
Address *
City, State, Zip *
Home Phone *
Cell Phone *
Email address *
What type of work are you applying for? *
What special qualifications do you have? *
What office machines can you operate? *
Are you 18 years or older? * Yes
No
Are you prevented from lawfully becoming employed in this country because of via or immigration status? * Yes
No

Special Purpose Questions

Height *
Weight *
Are you a U.S. citizen? * Yes
No
Have you ever been convicted of a felony or misdemeanor within the last 5 years? * Yes
No
If yes, describe: *
I have been advised that lie detector tests, as a condition of hiring or continued employment, are prohibited by law. Y e s No You will not be denied employment solely because of a conviction record, unless the offense is related to the job for which you have applied. Yes
No
I understand and agree that I may be required to take one or more: physical examination; lie detector test(s), as a condition of hiring or continued employment. I agree to consent to take such test(s) at such time as designated by the Company and to release the Company, its directors, officers, agents and employees from any claim arising in connection with the use of such test(s). Yes
No

Military Service Record

Branch of Service
Discharge Date
Rank
Present membership in National Guard or Reserves Yes
No
Date obligation ends

Education

School *
Number of years attended *
Name of School *
City *
Course *
Did you graduate? * Yes
No

Experience

Name & address of company *
Start date *
End date *
List your duties *
Starting & final salary *
Reason for leaving *
Name & address of company *
Start date *
End date *
List your duties *
Starting & final salary *
Reason for leaving *
Name & address of company *
Start date *
End date *
List your duties *
Starting & final salary *
Reason for leaving *

Business References

First & last name *
Address *
Occupation *
First & last name *
Address *
Occupation *
This form has been designed to strictly comply with the state and federal fair employment practice laws prohibiting employment discrimination. This Application for Employment Form is sold for general use throughout the United States. TOPS assumes no responsibility for the inclusion in said form of any questions which, when asked by the Employer of the Job Applicant, may violate State and/or Federal Law. *This form has been revised to comply with the provisions of the Americans with Disabilities Act and the final regulations and interpretive guidance promulgated by the EEOC on July 26, 1991.
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