Anthony Wayne Vending: Application

Please fill out the application below and submit when finished. A representative will be in contact with you shortly. In order to be considered for employment the application MUST be completed in full.

Contact Info
First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Cell:
Email:
Personal History
Date of Birth:
Military Record
Have you ever been in the armed forces?
Are you now a member of the National Guard?
Specialty:
Date Entered:
Discharge Date:
Criminal Record
Have you ever been convicted of a crime:
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentences(s) imposed, and type(s) of rehabilitation:
Driving Record
Do you have a driver's license?:
What is your means of transportation to work:
Driver's License Number:
State of Issue:
License Type:	(Operator, Commercial (CDL), Chauffer)
How many accidents have you had in the past three years?
How many moving violations have you had in the past three years?
Personal References Please list two references other than relatives or previous employers.
Name:
Position:
Company:
Address:
Telephone:

Name:
Position:
Company:
Address:
Telephone:
Employment History
May we contact your present employer?
1.) most recent
Company Name:
Address:
Company Phone:
Dates of Employment:
Supervisor Name:
Position:
Duties:
Starting Pay:
Current Pay:
Reason Left:

2.)
Company Name:
Address:
Company Phone:
Dates of Employment:
Supervisor Name:
Position:
Duties:
Starting Pay:
Ending Pay:
Reason Left:

3.)
Company Name:
Address:
Company Phone:
Dates of Employment:
Supervisor Name:
Position:
Duties:
Starting Pay:
Ending Pay:
Reason Left:
Education & Training
High School:
Did you graduate?	Yes No
Major:

University:
Did you graduate?	Yes No
Major:

Other Training:
Employment Availability
Position applied for:
Salary Desired:
How many hours can you work weekly?
Can you work nights?
Employment desired:	(Full-time, Part-time, or Either)
When available for work?
How did you learn about this opportunity?
Have you ever applied before? If so, when?
Resume File (optional):