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About LCA
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Architectural Control Guidelines
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Office Hours
A-Z
Member Resources
Welcome
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Architectural Control Submission form
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Statement of account request
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EMPLOYMENT APPLICATION FORM
Date
MM slash DD slash YYYY
Full Name
First
Middle
Last
Street Address
Street Address
City
State
ZIP
Phone Number
Business Phone Number
Type of School
Name of School
Location City & State
Dates Attended
Overall Grade Average
Diploma Or Degree
Major Field or Course of study
Type of School
Name of School
Location City & State
Dates Attended
Overall Grade Average
Diploma Or Degree
Major Field or Course of study
Type of School
Name of School
Location City & State
Dates Attended
Overall Grade Average
Diploma Or Degree
Major Field or Course of study
Type of School
Name of School
Location City & State
Dates Attended
Overall Grade Average
Diploma Or Degree
Major Field or Course of study
Subjects Liked Best
Why?
Subjects Liked Least
Why?
Scholarships Received
Scholastic or Other Honors
Extracurricular Activities
Do you plan to continue your education?
Yes
No
If so when and in what field
College Expenses Earned (%)
How were they earned?
SKILLS:
Computers
Software
Typing Speed
Calculator
Phones
Other
Please List in chronological order, giving present or last position first
Do not include military service
Present or last employer
(Students state last summer job)
Name of Firm
Position Title
Phone Number
Address
Immediate Supervisor
Nature of Duties
Starting Salary ($)
Last Salary ($)
Start Date
End Date
Reason for Leaving
Previously employed by
Name of Firm
Position Title
Phone Number
Address
Immediate Supervisor
Nature of Duties
Starting Salary ($)
Last Salary ($)
Start Date
End Date
Reason for Leaving
Previously Employed By
Name of Firm
Position Title
Phone Number
Address
Immediate Supervisor
Nature of Duties
Starting Salary ($)
Last Salary ($)
Start Date
End Date
Reason for Leaving
Have you ever served in U.S.Armed Forces?
Yes
No
Branch of Service
From
To
Type of Discharge
Honorable
General
Medical
Other
Other reason
Rank/Rate When Discharged
Date of Discharge
DD slash MM slash YYYY
Training, duties and responsibilities in military service
Present membership in any U.S. Military organization
Hobbies & Recreations
Name of relative in our employ
Name of friend in our employ
What influenced you to apply at this company
Have you ever been convicted, pleaded guilty or pleaded nolo contendere to any felony or to any misdemeanor involving violence or dishonesty?
Yes
No
If yes, explain fully:
Position Desired
Starting Salary Expected
Employment Planned:
Permanent
Temporary
Part time
Preferred Starting Date
Please read carefully before submitting the form:
I understand that the information given in this application will be treated as confidential. I certify that all statements and representations made in this application are true and correct and I have withheld nothing which would, if disclosed, adversely affect my application. I understand that the Association relies upon such statements in making its employment decisions, and I authorize the Association to investigate all such statements contained herein. I understand and agree that: any misrepresentation will be sufficient cause for cancellation of the application and/or for separation from the Association if such misrepresentation is discovered at any time after my employment by the Association. I further understand that applicants hired shall be on a ninety (90) day probationary period, but employment with the Association is always at will. I am aware that the use of this form does not indicate that there are any positions open, and does not in any way obligate the Association to employ me. I hereby authorize the Association to contact all employers specified in this application for the purpose of an employment reference, and I release all such persons and companies from any liability in responding to such requested information. In the event of my employment, I agree to abide by all rules and regulations of the Association. I understand that any offer of employment I am made is conditional on my passing a pre-employment physical [and drug test] prior to beginning work.
*
I hereby acknowledge that I have read and understood the above statements.