Please fill out the application below to apply for a position.
Social Security Number:
Are You 18 Years or Older?
Date You Can Start:
Are You Employed Now?
If So, May We Inquire of Your Present Employer?
Ever Applied to this Company Before?
Ever Worked for this Company Before?
Reason for Leaving:
Name of Last Supervisor at this Company:
Who Referred You to this Company:
Name and Location of School:
Number of Years Attended:
Did You Graduate?
Subjects of Special Study or Research Work:
List below the last three employers, starting with the most recent.
Name of Present or Last Employer:
Weekly Starting Salary:
Weekly Final Salary:
May We Contact Your Supervisor?
Name of Supervisor:
Description of Work:
Name of Previous Employer:
Branch of Service:
Have You Ever Been Convicted of a Felony?
If Yes, Explain: (Will not necessarily exclude you from consideration)
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.”
I Agree with the Authorization Terms Above
Williamsburg Furniture Inc.
2096 Cheyenne St, Nappanee, IN, 46550|