Employment Application - Step I

  APPLICANT INFORMATION
Last Name
First Name
M.I
Date
Street Address
Apartment/Unit #
City
State
Zip
Phone
E-mail Address
Date Available
Social Security No.
Desired Salary
Position Applied for
Are you a citizen of the United States? Yes
No
  If no, are you authorized to work in the U.S.?   Yes No
Have you ever worked for this company? Yes
No
  If so, when?
Have you ever been convicted of a felony? Yes
No
  If yes, explain
 
  EDUCATION
High School
Address
From
To
  Did you graduate?
Yes  No
  Degree
  
College
Address
From
To
  Did you graduate?
Yes  No
  Degree
 
Other
Address
From
To
  Did you graduate?
Yes  No
  Degree
  
 
  REFERENCES
Please list three professional references.
 
Full Name
Relationship
Company
Phone #
Address
Full Name
Relationship
Company
Phone #
Address
Full Name
Relationship
Company
Phone #
Address





Office Hours (Mtn Standard Time):
Mon-Sat 7:00 am to 6:30 pm, Sun 10:00 am to 6:30 pm
Winter Hours: Mon-Fri 8:00 am to 5:00 pm


After hours: please call 307-765-2080 to leave a message. We will get back to you.
 
Office Phone: 307-765-2080 Fax: 307-765-2681
Toll-Free 1-800-354-8637
On-call staff person answers toll-free line after hours.

P.O. Box 206, Shell, WY 82441 

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