Employment Application Name * First Name Last Name Email * Phone * (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Date Available * MM DD YYYY Desired Salary $ Position Applied For Are you a citizen of the United States? Yes No If no, are you eligible to work in the U.S.? Yes No Have you ever worked for this company? Yes No If yes, when? Have you ever been convicted of a felony? Yes No If yes, explain: EDUCATION High School Name/Address Did you graduate? Yes No Degree Received College Name/Address Did you graduate? Yes No Degree Received Other Did you graduate? Yes No Degree/Certificate Received Full Name Relationship Company Phone (###) ### #### Full Name Relationship Company Phone (###) ### #### Full Name Relationship Company Phone (###) ### #### PREVIOUS EMPLOYMENT Company Phone (###) ### #### Address Supervisor Job Title Starting Salary $ Ending Salary $ Responsibilities Start Date MM DD YYYY End Date MM DD YYYY Reason for Leaving * May we contact your previous supervisor for a reference? Yes No Company Phone (###) ### #### Address Supervisor Job Title Starting Salary $ Ending Salary $ Responsibilities Start Date MM DD YYYY End Date MM DD YYYY Reason for Leaving May we contact your previous supervisor for a reference? Yes No MILITARY SERVICE Branch Start Date MM DD YYYY End Date MM DD YYYY DISCLAIMER AND SIGNATURE Butterfly Cathedral, LLC dba The Butterfly Palace is an equal opportunity employer and does not discriminate against other qualified applicants based on race, color, creed, religion, age, sex, national origin, disability or handicap, or veteran status. If this application leads to employment, I understand that making false or misleading information in my application or interview may result in my release. I understand that this application does not constitute a contract of employment. I authorize The Butterfly Palace to verify information regarding my education, employment history and any other information listed on this application. By typing your name below, you agree that your electronic signature is the legal equivalent of your manual signature on this application. Signature Date MM DD YYYY Thank you!
