West Bend, WI Application
First Name
Last Name
Middle Initial
Email
Street Address
City/State
Zip Code
Phone Number

If hired, can you provide evidence of legal eligibility to work in the U.S.?
Any offer of employment is conditioned upon completing form I-9 and providing the appropriate documents for identity and work authorization.

Position Desired
Wage/Salary Desired
Date you can begin work
Are you 18 years of age or older?
If under 18 years of age, you will be required to submit a birth certificate or work certificate as required by state or federal law.

Name of Highschool Attended
City and State
Graduate?
GED?
Name of college or technical school:
City and State
Graduate?
Degree?
Major
Are you presently enrolled in school?
If yes, give name & address of school and expected degree date

List any job-related skills or accomplishments, including military service:
Your availability for work
Total hours per week you are available to work
Do you have any special requests or needs for a work schedule?
- Provide Three References Who Are Not Former Employers Who We May Contact -
Name and Occupation
How do you know them, and for how long?
Phone Number

Name and Occupation
How do you know them, and for how long?
Phone Number

Name and Occupation
How do you know them, and for how long?
Phone Number