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The loyalty we enjoy in our customer base is directly related to the loyalty we have experienced in our great employees. Many of our personnel have been with us for decades and, for some, working at Jerry’s has developed into that sort of career they never want to leave. If you want to be considered by Jerry’s for the opportunity of employment, feel free to come in the store and fill out an application.

Application Date

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PERSONAL INFORMATION

Name:

Address:

Last

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First

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Middle

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Street

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City

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State

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Phone No.

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Email

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Referred by

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Are you 18 years of age older?

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EMPLOYMENT DESIRED

Position

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Date you can start

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Salary desired

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Are you employed now?

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If so may we inquire of your present employer?

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AVAILABLE TO WORK

Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday Any available
Hours

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FORMER EMPLOYERS

List below your last four employers, starting with the last one first.

Date
Month & Year

Name & address of employer

Salary
(upon leaving)

Position

Reason for leaving

From

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To

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From

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To

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From

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To

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From

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To

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GENERAL

Subjects of Special Study or Research Work

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Job Related Skills (typing, driver's license, etc.)

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Activities other than religious

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REFERENCES

List below three persons not related to you, whom you have known at least one year.

Name

Address

Position

Years Acquainted

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EDUCATION

Grammar School

High School

College

Others

Name & location of school

Last year
completed

Did you
graduate?

Subjects studies
& degree(s) received

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(* Required)

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(* Required)

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