(PRE-EMPLOYMENT QUESTIONNAIRE) (AN EQUAL OPPORTUNITY EMPLOYER)

 
Applicant Personal Information
First Name MI Last Name
Address - Street / P.O. Box / R.R. & Box #
City State Initials Postal Code
Day Phone Evening Phone E-mail Address
   
Area Code Number Area Code Number yourname@yourhost.com

 
Social Security Number

 

Employment Availability and Special Qualifications
What kind of work are you applying for? What special qualifications do you have?
What office machines can you operate?

 

Special Purpose Questions
Are you either a U.S. citizen or an alien authorized to work in the United States?
Are you at least 18 years of age or older?
Have you been convicted of a felony or misdemeanor in the last 5 years?*
If you answered Yes to the above question, please explain below
*You will not be denied employment solely because of a conviction record, unless the offense is related to the job for which you have applied

 

Military Service Record
Have you served in the U.S. Armed Forces?
Branch of Military that you served in.
Dates of Military Service From: To:
Rank at Enlistment Rank at Separation
Present membership in National Guard or Reserves Date obligation ends

 

Education
SCHOOL
*NO. OF YEARS ATTENDED
NAME OF SCHOOL
CITY
COURSE
*DID YOU GRADUATE?
Grammar
High
College
Other
*The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.

 
Experience
NAME & ADDRESS OF COMPANY
DATE
FROM TO
LIST YOUR DUTIES
STARTING
SALARY
FINAL
SALARY
REASON FOR LEAVING

 
Business References
NAME
ADDRESS
OCCUPATION

 
 

Summit Aviation   4200 Summit Bridge Road   Middletown, DE 19709

TOLL FREE: 1-800-441-9343   MAIN: (302) 834-5400

MAIN FAX: (302) 378-7035   PARTS FAX: (302) 378-7196

www.summit-aviation.com