Chris Doxzen 

                  and Associates, L.L.C.

Employment Application

  

Please complete the following Employment Application with as much information as possible so that we may facilitate a speedy response. Please note that submission of this application does not guarantee acceptance by Chris Doxzen and Associates, L L.C..

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First Name:    Position Sought:
Middle Name: 
Last Name:   
Address:     
City:         State:  Zip:
Home Phone:  
Work Phone:  
Cell Phone:  
E-Mail:      
Alternate Contact:   Alternate Contact Phone: 
Social Sec. # Security Clearance


Employment History


Present/Previous From to 
        Company: Title:
Company Address: 
           City:  State:    Zip: 
Supervisor PhoneComp. Website
Type of Firm:  Duties:
Salary Start Work Schedule(M-F) Computer 
  Salary End Hours per week:    Company Staff
       Bonus 
Reason for leaving: 

Previous Position  Fromto 
        Company: Title:
Company Address: 
           City:  State:    Zip: 
SupervisorPhoneComp. Website
Type of Firm:  Duties:
Salary Start Work Schedule(M-F) Computer 
  Salary End Hours per week     Company Staff:
       Bonus 
Reason for leaving: 


Previous Position  Fromt0 
        Company: Title:
Company Address: 
           City:  State:    Zip: 
SupervisorPhoneComp. Website
Type of Firm  Duties
Salary Start Work Schedule(M-F) Computer 
  Salary End     Hours per week Company Staff:
       Bonus 
Reason for leaving:  

Education/Training

H.S.  Attended From mm/dd/yyyy:to:
LocationDeg. Earned  Major

College  Attended From mm/dd/yyyy:to:
LocationDeg. Earned  Major

Grad Sch.  Attended From mm/dd/yyyy:to:
LocationDeg. Earned  Major

Other  Attended From mm/dd/yyyy:to:
LocationDeg. Earned  Major

 

Personal Skills and Talents

        Skills                    Languages                            
   Typing          WPM       Language:Fluent?   
   Shorthand   WPM       Language:Fluent?   
   Dictation     WPM       Language:Fluent?

Equipment/Software

Professional References (co-workers familiar with your work)

 

  1   Name: Position:   Company: 
  Location: Wk Ph: Hm Ph:  
  2   Name: Position:   Company: 
  Location: Wk Ph: Hm Ph: 
  3   Name: Position:   Company: 
  Location: Wk Ph: Hm Ph: 
  4   Name: Position:   Company: 
  Location: Wk Ph: Hm Ph:

Prior Job Search

For how long have you been actively job searching ? 

  1   Company: Loction:              Position: 
    Interviewer:   Source: Current Status: 
    
  2   Company: Loction:              Position: 
    Interviewer:   Source: Current Status: 
    
  3   Company: Loction:              Position: 
    Interviewer:   Source: Current Status: 

* PLEASE READ CAREFULLY * PLEASE READ CAREFULLY *PLEASE READ CAREFULLY *


Any and all referrals we may make to our employer clients of our employee candidates is based solely upon merit and are not made based upon race, creed, sex, sexual partner preference, age, national origin, ancestry, marital status, parental status, income or its source(s), military discharge status or any other status therein attributed to the candidate through association with any group which is protected by law, personal disability or handicap which does not bear upon the requirements of the client's employment position as defined in the job description.

By submitting this employment application, applicant hereby authorizes Chris Doxzen and Associates, L.L.C. and/or its agents or assignees to conduct a background check of applicant which shall not be limited to the information submitted herein and which may include investigation for any criminal record, felony conviction(s) and veracity of information submitted herein. Applicant further is aware of his or her right, according to the Fair Credit Reporting Act, to be given full disclosure of the nature and substance of any and all background investigations conducted by Chris Doxzen and Associates, L.L.C. .

As a courtesy, we request whether or not we have your permission to contact your current employer?

Yes, you may contact my current employer.

No, please do not contact my current employer.

                Thank you! Chris

Submission of this application does not guarantee acceptance by Chris Doxzen and Associates, L.L.C. and does not obligate either the applicant or Chris Doxzen and Associates, L. L. C.
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