AMI Employment

Name:

Address:

City:

State and Zip:

Date of Birth:

Phone:

Social Security Number:

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?

YES
NO

Position Desired:

Date you can start:

Salary Desired:

Are you employed now?

YES
NO

Present Employer Name/Phone Number:

May we contact present employer?

YES
NO

Have you ever applied with AMI before?

YES
NO

If yes, when?

Name and location of High School:

Years Attended:

Did you graduate?

YES
NO

Name and location of College, Trade, Business or Correspondence School:

Years Attended:

Did you graduate?

YES
NO

Subjects Studied?

Special Skills:

Activities (Civic, Athletic, Etc):

U.S. Military or Naval Service / Rank:

Present Membership in Guard or Reserves?

YES
NO

Previous Employer Name & Address:

Salary:

Position:

Dates of Employment:

Reason for Leaving:

Previous Employer Name & Address:

Salary:

Position:

Dates of Employment:

Reason for Leaving:

Previous Employer Name & Address:

Salary:

Position:

Dates of Employment:

Reason for Leaving:

Which job did you like the best and why?

Have you ever signed an employment contract?

YES
NO

Have you ever signed a non-compete contract?

YES
NO

Have you ever been convicted of a felony?

YES
NO

Emergency Contact

Relationship to you

Phone Number

References: Person (not related to you), Address, Years Acquainted

References: Person (not related to you), Address, Years Acquainted

References: Person (not related to you), Address, Years Acquainted

I certify that all the information submitted by me on this application is true and complete and I understand that if any false information, omission or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations and I agree that my employment can be terminated with or without cause and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the President, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

Date:

Signature: