Street:

City:

State:

Zip code:

Best time to contact you:

Date you can start:

What shift do you prefer?:

Work Experience:

Start with your present or last job.

Employer:

Address:

Phone #:

Job title:

Supervisor:

Reason for leaving:

Date employed from:

Date employed to:

Starting hourly rate:

Final hourly rate:

Work performed:

May we contact them? yes no

Employer:

Address:

Phone #:

Job title:

Supervisor:

Reason for leaving:

Date employed from:

Date employed to:

Starting hourly rate:

Final hourly Rate:

Work performed:

May we contact them? yes no

Name of high school

Diploma:

Name of college:

Degree:

Other:

Name:

Phone #:

Occupation:

Name:

Phone #:

Occupation:

Name:

Phone #:

Occupation:

I certify that answers given herin are true and complete. I understand Pennsylvania is an at-will state, which means that the Employee may resign at any time and the Employer may discharge the Employee at any time with or without cause. I understand that as an applicant I may be subject to drug testing.

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any legally protected status.

InkPixi Seasonal Job Application

Current address:

Work Experience:

Education:

Specialized Skills:

(Skills / Equipment Operated)

Personal / Professional References: