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Application

This document is a job application form that collects personal information, employment history, education, and references from applicants. It includes sections for the desired position, authorization for background checks, and a statement certifying the accuracy of the provided information. The form also provides contact details for submitting the application to Lanzo Companies.

Uploaded by

brianschade85
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
26 views2 pages

Application

This document is a job application form that collects personal information, employment history, education, and references from applicants. It includes sections for the desired position, authorization for background checks, and a statement certifying the accuracy of the provided information. The form also provides contact details for submitting the application to Lanzo Companies.

Uploaded by

brianschade85
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PERSONAL INFORMATION DATE: ________________________

Name (Last Name First) Social Security Number

Present Address City State Zip Code

Permanent Address City State Zip Code

Phone No. Referred By

EMPLOYMENT DESIRED
Position Date You Can Start Salary Desired

Are you employed now? If so, may we inquire of your present employer? Are you legally authorized to work in the US?
_____ Yes _____ No _____ Yes _____ No _____ Yes _____ No

Have you applied to this company before? Where? When?


_____ Yes _____ No

EDUCATION HISTORY
NAME & LOCATION OF SCHOOL YEARS ATTENDED DID YOU GRADUATE? SUBJECTS STUDIED

High School

College

Trade, Business or
Correspondence
School

GENERAL INFORMATION
Subjects of special
study/research work

Special Training

Special Skills

US Military or Rank
Naval Service
FORMER EMPLOYERS (List below last four employers, starting with last one first)
Date: Month & Year Name & Address of Employer Salary Position Reason for Leaving
From
To
From
To
From
To
From
To

REFFERENCES (Please provide the names of three people not related to you whom you have known at least one year.)
Name Address Business Years Known

AUTHORIZATION
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand
that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you
any and all information concerning my previous employment and any pertinent information they may have, personal or
otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for
employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing
and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a mariner prohibited by the
Americans with Disabilities Act (ADA) and other relevant federal and state laws.”

DATE: ___________________ SIGNATURE: _________________________________________________________

INTERVIEWED BY: _____________________________________________________ DATE: __________________

You can drop off your application in person or mail or fax the application to:
Lanzo Companies
125 S.E. 5th Court
Deerfield Beach, Florida 33441-4749
Phone: (954) 979-0802
Fax: (954) 979-9897

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