APPLICATION FOR EMPLOYMENT (v022306)

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION:
Full Name:
SSN:
Address:
City:
State:
Zip:
Telephone:
Email:
Position Applying For:
Are you at least 18 Years Old?	Yes No
Are you a U.S. Citizen?	Yes No
If not, do you have proof of your legal right to live and work in this country?	Yes No
Are You A Veteran?	Yes No
Branch of Service:
Are you able to perform the essential functions of the job for which you are applying, either with or without accommodation?	Yes No
If no, describe the functions that cannot be performed. (Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees.)
Have you ever been convicted of a criminal offense (felony or serious misdemeanor)?	Yes No
If yes, state the nature of the crime(s), when and where convicted and disposition of the case. (Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, date of the offense, the surrounding circumstances, and the relevance of the offense to the position(s) applied for may, however, be considered.)



EDUCATION HISTORY: (please furnish all that apply)
High School:
Did You Graduate?	Yes No

College/University Name:
Did You Graduate?	Yes No
Degree/Certification:

Business/Tradeschool Name:
Did You Graduate?	Yes No
Degree/Certification:



EMPLOYMENT HISTORY 1 of 2: (begin with recent position)
Firm Name:
Address:
Phone:
Supervisor:
Nature of Business:
Dates of Employment:
Position(s) Held:
Ending Salary:
Reason for Leaving:
Supervisor Phone #:
Job Duties:
May We Contact:	Yes No

EMPLOYMENT HISTORY 2 of 2:
Firm Name:
Address:
Phone:
Supervisor:
Nature of Business:
Dates of Employment:
Position(s) Held:
Ending Salary:
Reason for Leaving:
Supervisor Phone #:
Job Duties:



PROFESSIONAL REFERENCES 1 of 2: (please furnish the names, addresses, and phone numbers of two people to whom you are not related and who are not former employers)

Name:
Company:
Address:
Phone Number:

PROFESSIONAL REFERENCES 2 of 2:

Name:
Company:
Address:
Phone Number:


ADDITIONAL INFORMATION:
Please supply additional info if applicable:

DISCLAIMER AND ACKNOWLEDGEMENT: I certify that the information contained in this application is true and complete to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired. I authorize AES to investigate and make inquiries of my personal, employment, and educational history as necessary for my potential employment with AES. I hereby authorize any person, organization or company listed on this application to furnish AES any and all information concerning my previous employment, education and qualifications for employment. I also authorize AES to request and receive such information. I understand that nothing contained in the application or conveyed during any interview is intended to create an employment contract between AES and me.

I agree to the above terms