Name *

First Name

Last Name

Date *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Hours Desired *

Full Time

Part Time

Are you over 18 years old? *

Yes

No

Are you legally eligible to work in the United States? *

If offered employment employment, you will be required to provide documentation to verify eligibility.

Yes

No

Have you every been employed in any facility of Artisans? *

Yes

No

Can you work overtime, including weekends? *

Yes

No

Are you able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation? *

Yes

No

Number of Years Completed *

Check One

1

2

3

4

Diploma *

Yes

No

G.E.D. *

Yes

No

Number of Years Completed

Check One

1

2

3

4

Select all that apply

Data Entry

Excel

Word Processing

MSWord

May we contact your present employer? *

Yes

No

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Have you ever been discharged or asked to resign from a job? *

Yes

No

During the last ten years, have you ever been convicted of a crime other than a minor traffic offense? *

Yes

No

Reference 1

First Name

Last Name

Phone

(###)

###

####

Reference 2

First Name

Last Name

Phone

(###)

###

####

Reference 3

First Name

Last Name

Phone

(###)

###

####

Reference 1

First Name

Last Name

Phone

(###)

###

####

Reference 2

First Name

Last Name

Phone

(###)

###

####

Reference 3

First Name

Last Name

Phone

(###)

###

####

Date *

MM

DD

YYYY