Employment Application

    Date:   Social Security Number: 
    Name: ,
    Present Address
    ,  
    Permanent Address
    ,  
    Phone No:  Are you at least 18 years of age?  YesNo
    Email Address:
    Name and Dept. of any relatives employed by Valley Offset Printing
    How did you hear about us?  AdvertisementEmployment AgencyFriendRelativeOther

    Shift Preferred:  Position:  Salary:
    Date You Can Start:   Will You Work Overtime If Needed?  YesNo
    If Employed, May We Inquire of Your Last Employer?  YesNo
    Have You Ever Applied at Valley Offset Printing Before?  YesNo If YES, When? 
    Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?  YesNo

    High School
    Year Completed:  1234
    Graduated?  YesNo

    College
    Year Completed:  1234
    Graduated?  YesNo

    Trade or Business School
    Year Completed:  1234
    Graduated?  YesNo

    As an Equal Opportunity Employer, Valley Offset Printing will not discriminate against any employee or applicant for employment because of race, religion, sex, age, national origin, disability, veteran’s status or any other unlawful basis

    List your last four (4) employers beginning with the most recent
    First
    Date - Month & Year
    Name Of Employer & Supervisor
    Address
    Position & Salary
    Reason For Leaving



    Second
    Date - Month & Year
    Name Of Employer & Supervisor
    Address
    Position & Salary
    Reason For Leaving



    Third
    Date - Month & Year
    Name Of Employer & Supervisor
    Address
    Position & Salary
    Reason For Leaving



    Fourth
    Date - Month & Year
    Name Of Employer & Supervisor
    Address
    Position & Salary
    Reason For Leaving



    List below the names of three persons NOT related to you, whom you have known at least one year.
     
    Name
    Address
    Business
    Years Acquainted
    1.
    2.
    3.
    Have you ever been convicted of a felony?  YesNo
    Please provide details: 
    In case of emergency, notify:

    I authorize investigation of all statements contained in this application and I release all references listed above, schools, current and past employers, from all liability for any damage or claim that may result from furnishing information to Valley Offset Printing. I understand that misrepresentation or omission of facts requested will result in refusal to employ me or my dismissal if I am employed. Further, I understand and agree that my employment is for no definitive period and may, regardless of date of employment or any wages and salary, be terminated at any time, with or without my previous notice, at the option of either Valley Offset Printing or me.
    Date: