Employment

First Name *

Middle Initial *

Last Name *

Phone *

Email *

Address

City

State

Zip

Job Details

Referred by

Please Name Source (if answered other)

Are you legally eligible for employment in the USA?

Yes

Date of Birth *

Position applying for

Salary expected

Are you available to work

Full-Time

Part-Time

Scheduling

Specify schedule limitations NOT AVAILABLE TO WORK AT PREPLAYED (ex: school schedule, first/other job schedule)

Date available for work

List friends or relatives in our employ

Previous Employment With Us

Were you previously employed by us

Yes

If yes, when

Other name(s) used while attending schools or places of employment indicated on this form

Background

Can you perform the functions of this job with or without reasonable accommodations

Yes

If No, please explain

Have you ever been convicted of a felony

Yes

If yes, please explain (A conviction alone will not automatically bar you from employment)

Education

High School – Name and Location

Course of Study

Currently Enrolled

Yes

What year did you / do you plan to graduate

College – Name and Location

Course of Study

Currently Enrolled

Yes

What year did you / do you plan to graduate

Degree

Other – Name and Location

Course of Study

Currently Enrolled

Yes

What year did you / do you plan to graduate

Degree

Military Service

Yes

Brach of service and rank

Dates of Service

Special Training

Current / Most Recent Employer

Address

Supervisor

Salary

Phone

Job Title

Date Started

Date Left

Job Description

Reason for Leaving

Explain

Second Most Recent Employer

Address

Supervisor

Salary

Phone

Job Title

Date Started

Date Left

Job Description

Reason for Leaving

Explain

Third Most Recent Employer

Address

Supervisor

Salary

Phone

Job Title

Date Started

Date Left

Job Description

Reason for Leaving

Explain

References

First Reference Name

Relationship to Reference

Occupation

Address

Phone

Second Reference Name

Relationship to Reference

Occupation

Address

Phone

Third Reference Name

Relationship to Reference

Occupation

Address

Phone

Additional Information

Please summarize any additional information necessary to fully describe your qualifications.

PLEASE READ All information written on this application is complete and accurate to the best of my knowledge. I understand that any misrepresentation of facts in this application disqualifies me from further consideration – or if employed – is grounds for dismissal. I understand that any employment offer is contingent upon satisfactory references and I authorize PrePlayed to investigate past employment and education history, as well as references given on application.

I understand that if employed such employment may be terminated for just cause, or no cause, by management at any time. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its management, and then only when in writing and signed by the management, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

I fully understand and agree to all statements above. *

Yes

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