Your Foxfire career starts here! 1 Applicant Information2 Education Information3 References4 Employment History5 Finish Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email Social Security NumberDate available to start work Date Format: MM slash DD slash YYYY Employment Type Requested*Full TimePart TimeNo PreferencePosition applying for?What days/hours are you available?Are you a United States Citizen?*YesNoIf NO above, are you authorized to work in the U.S.?*YesNoHave you ever been convicted of a felony?*YesNoPlease explain*Do you currently take prescription medicine?*YesNoPlease explain* High SchoolNameLocationFrom Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Did you graduate?YesNoCollegeNameLocationFrom Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Did you graduate?YesNoDegreeOtherNameLocationFrom Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Did you graduate?YesNoDegree / Diploma ReferencesPlease list three professional references.Name*Relationship*Company*Phone*Name*Relationship*Company*Phone*Name*Relationship*Company*Phone* Current and Previous EmploymentCompany NamePhoneSupervisor NameAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Job TitleDate Started Employment Date Format: MM slash DD slash YYYY Date Ended Employment Date Format: MM slash DD slash YYYY Starting SalaryEnding SalaryResponsibilitiesReason for leaving?May we contact your previous supervisor for a reference?YesNoCompany NamePhoneSupervisor NameAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Job TitleDate Started Employment Date Format: MM slash DD slash YYYY Date Ended Employment Date Format: MM slash DD slash YYYY Starting SalaryEnding SalaryReason for leaving?May we contact your previous supervisor for a reference?YesNoResponsibilitiesCompany NamePhoneSupervisor NameAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Your Job TitleDate Started Employment Date Format: MM slash DD slash YYYY Date Ended Employment Date Format: MM slash DD slash YYYY Starting SalaryEnding SalaryReason for leaving?May we contact your previous supervisor for a reference?YesNoResponsibilities Finish your applicationI certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information on my application or interview may result in my release. Condition of Employment I understand the position description requirements and acknowledge that they are a condition of employment.Signature*
