Practice Application
Carleton Middle School
APPLICATION FOR EMPLOYMENT
Please complete pages 1-4; page 5 is optional. Date 5/23/17
Name Gajewski Cameron David Gajewski
Last First Middle Maiden
Present Address 28093 Wagner Warren Michigan 48093
Number/Street City State Zip
Home Phone (586) 944-7703 Cell Phone (586) 944-7703
Email 826615@student.wcskids.net Social Security No.(use only last 4 digits) XXX-XX-
1223
If under 18, please list age 14 Days/hours available to work
No Preference Thursday 4:00-8:00
Position applied for (1) Cashier Monday 4:00-8:00 Friday N/A
Tuesday N/A Saturday N/A
and salary desired (2) Minimum Wage
Wednesday 4:00-8:00 Sunday 1:00-5:00
How many hours can you work weekly? Can you work nights? No Yes
Employment desired FULL-TIME ONLY PART-TIME ONLY FULL- OR PART-TIME TEMPORARY
When are you available for work? Weekdays and Sunday
TYPE OF SCHOOL NAME OF SCHOOL LOCATION NUMBER OF MAJOR &
(High School, College, (Complete mailing address) YEARS DEGREE
Business or Trade COMPLETED OBTAINED
School, etc.)
High School Cousino 13, Hoover 0 N/A
HAVE YOU EVER BEEN CONVICTED OF A CRIME? No Yes
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s)
was/were committed, sentence(s) imposed, and type(s) of rehabilitation. An affirmative answer to this question will
not necessarily preclude employment; however a false answer will preclude employment.
APPLICATION FOR EMPLOYMENT
Please list three references other than relatives.
Name Bernard Kassab
Position Student
Company Carleton Middle School
Address 1234 Street st
Telephone (111)-111-1112
Name Agron Gojcaj
Position Student
Company Carleton Middle School
Address 1246 Street rd
Telephone (586) 586-5865
Name Tuyen Duddles
Position Teacher
Company Warren Consolidated Schools
Address 90747 Road av
Telephone (939) 678-1234
An application form sometimes makes it difficult for an individual to adequately summarize a complete background.
Use the space below to summarize any additional information necessary to describe your full qualifications for the
specific position for which you are applying.
I took advanced classes at Butcher Educational Center. Also I worked in a small lawn care service, employed by as
friend, where I learned about having a good work ethic.
APPLICATION FOR EMPLOYMENT
Work Experience
Please list your work experience (including any military experience) beginning with your most recently held job. If
you were self-employed, give firm name. Attach additional sheets if necessary.
Name of employer
Address Name of last Employment
supervisor dates Pay or salary
City, State, Zip Code From Start
Phone number To Final
Your last job
title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at
this company.
Name of employer
Address Name of last Employment
supervisor dates Pay or salary
City, State, Zip Code From Start
Phone number To Final
Your last job
title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at
this company. Small lawn care, watched siblings, and renovated rooms.
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at
this company.
May we contact your present employer? Yes No
Did you complete this application yourself? Yes No
If not, list name of person completing the application:
Signature of Applicant: Cameron Gajewski Date
5/24/17
