Color Me Mine - Employment Application

Personal Information

Your Name:

First:

Last:

M.I.:

Address:

City:

State:

Zip:

Phone:

Email:

Date Available:

Hours Available:

Please tell us what days & hours you can work.

Position Desired:

Hourly Wage Desired:

US Citizen:

Yes

No

If No, are you authorized to work in the US?

Yes

No

Have you ever worked at a Color Me Mine?

Yes

No

Where?

When?

Have you been convicted of a felony?

Yes

No

If yes, please explain:

Education

High School:		Year Graduated:
City& State:

College:		Year Graduated:
City & State:		Degree:

Other:		Year Graduated:
City & State:		Degree:

References (Please provide two personal references)

Name:

Relationship:

Address:

Phone:

City:

State:

Zip:

Name:

Relationship:

Address:

Phone:

City:

State:

Zip:

Employment History (Provide Information about your previous two jobs)

Company One

Phone:

Address:

Supervisor:

City:

Your Job Title:

State:

Zip:

Starting Date:

Starting Wage:

End Date:

Ending Wage:

May we contact this employer for a reference?

Yes No

Company Two:

Phone:

Address:

Supervisor:

City:

Your Job Title:

State:

Zip:

Starting Date:

Starting Wage:

End Date:

Ending Wage:

May we contact this employer for a reference?

Yes No

Additional Comments:

Security Code Type in this number below

By submitting this employment application I herein certify that the answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in this employment application or interview may result in my release. I also understand that by submitting this application, I herein authorize Color Me Mine to conduct pre-employment screening (as authorized above) which may include employment verification, reference checks and/or a criminal background check.

Employment Application . . .