Millennium Technologies | Application for Employment

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APPLICATION FOR EMPLOYMENT

- Step 1 of 4

Contact Information

First Name *

Middle Name

Last Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Are you a US citizen? *

Yes
No

Have you ever been convicted of a felony? *

Yes
No

Position for which you are applying for *

Available start date *

Current Employer Information

Are you currently employed? *

Yes
No

Current Employer Name *

Current Employer Address *

Address Line 1

Address Line 2

City

State

Zip Code

How long have you been working for this employer? *

Current salary/wage

Previous Employer History

Please list your previous employers NOT including your current employer from most recent to oldest.

1. Employer Name

Phone Number

Position(s) Held

Start Date

End Date

2. Employer Name

Phone Number

Position(s) Held

Start Date

End Date

3. Employer Name

Phone Number

Position(s) Held

Start Date

End Date

4. Employer Name

Phone Number

Position(s) Held

Start Date

End Date

Have you ever been dismissed or asked to resign from a position? *

Yes
No

If yes, please explain *

***A yes answer to the above question does not necessarily disqualify an applicant from employment***

Education

High School

***Please list all schools attended and any other pertinent information about your education***

Graduation Date

Subjects Studied

***If applicable***

College/Technical College/Trade School

***Please list all schools attended and any other pertinent information about your education***

Graduation Date

Subjects Studied

***If applicable***

Other relevant information to your education career

Can you type? *

Yes
No

If yes, how many words per minute?

Please provide computer and software knowledge below

Documents

Cover Letter

Click or drag a file to this area to upload.

***If you have a cover letter please upload it here***

Resume

Click or drag a file to this area to upload.

***If you have a resume please upload it here***

Reference Page

Click or drag a file to this area to upload.

***If you have a reference page please upload it here***

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