Job Application for Alliance Communications Network

We appreciate your interest in our company. This form has been designed to provide us with the information we will need to consider your qualifications. Please do not hesitate to attach any additional information which might be of assistance in considering your application.

Please fill out the form below to apply for a job opening at Alliance Communications. You may attach a resume at the end of the form. Your information is secure and confidential.

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PERSONAL DATA

Name in Full:
Social Security Number:
Street Address:
City:   State:   Zip:
Telephone:
How Were You Referred to Us?
Would You Work Any Shift?: Yes No       Date Available:     Salary Expected:
Position Applied for:

EDUCATIONAL TRAINING

Name of School
Location
Did You Graduate?
Major
High School:
Yes  No
Business/Vocational:
Yes  No
College/University:
Yes  No
Other School:
Yes  No
Do you plan to continue your education?    Day School  Night School

SKILLS

Use space below for any other experience, skills or qualifications which you feel would especially qualify you for the position you are seeking. (Typing, shorthand, CRT, CATV system, construction, system maintenance, local organizations, FCC licenses held, etc).

REFERENCES

Give the names and addresses of at least two adults (not relatives or previous employees) who are acquainted with you and to whom we can refer concerning your character and ability.
Name
Address
Telephone
Occupation
No. of Years Aquainted

EMPLOYMENT HISTORY

Name of Employer:
Type of Business:
Address:
Telephone:
Dates Employed:
  From  To   Starting Title   Last Title 
Starting Salary:
  Final Salary   Name of Supervisor:
Reason for Leaving:
Description of Duties:
 
Name of Employer:
Type of Business:
Address:
Telephone:
Dates Employed:
  From  To   Starting Title   Last Title 
Starting Salary:
  Final Salary   Name of Supervisor:
Reason for Leaving:
Description of Duties:
 
Name of Employer:
Type of Business:
Address:
Telephone:
Dates Employed:
  From  To   Starting Title   Last Title 
Starting Salary:
  Final Salary   Name of Supervisor:
Reason for Leaving:
Description of Duties:

OTHER INFORMATION

If applying for a job, where you will be driving a company vehicle, complete the following:
Do you have a valid Driver's License? Yes   No Have you had your driver's license revoked in the last 5 yrs? Yes   No
License #: State: Have you been convicted of a DWI or any other moving violations within the last 5 yrs? Yes   No
IF the answer to either question is Yes, please explain:
If now employed, why do you desire to make a change?
Have you ever been convicted of a felony? Yes   No

Attach resume: (.doc, .pdf. and .jpg files only)
 
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