[Company Name] is an equal opportunity employer. [Company Name] does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.
Employee name: ___________________________________________________
Phone number: ____________________ Email address: ___________________
Current position: ______________________________________________
Current department: ____________________________________________
Hire date: _______________
Position applying for: _________________________________________
Can you perform the essential functions of this job with or without reasonable accommodation? (If you have any questions about the functions of the job, please ask the hiring manager before answering this question.) YES [] NO []
Describe your current qualifications for the position including education, skill, abilities, work habits and work experience (attach resume if applicable):
Explain why you are applying for this position:
By signing below you signify that all information contained above is accurate, that you have read the job posting and you understand, are able and willing to perform the functions and duties of that position. Your current supervisor must approve of any job application.
Employee signature: _______________________________ Date: ___________
Approval of application:
Supervisor signature: _______________________________ Date: ___________
Human resources signature__________________________ Date: ___________