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302 Adams Street

Manchester, Connecticut     06040

(860)  646-3581      fax (860) 643-2124

 

 
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PRELIMINARY EMPLOYMENT APPLICATION

 

How did you hear about Fibre Optic Plus, Inc.?

Guidance consoler     Friend      Co-worker    Web search

 
 

Enter your information in the space provided below.

     Name :    First   Middle     Last 

Address                       Social Security Number  

 

City     State     Zip
 
Home Telephone            Cellular         Pager 
 
 
Education
 
Highest level of school completed?        Trade school?
Other work or trade experience? 
                                                                                                                    
 
Work History
List all employers for the last FIVE Years beginning with the most current.
 
 

Dates Employed            From  To 

Companies Name       Companies Address 

City         State      Zip  

 
Job description / Duties    
 
 
Reason for leaving:
 
 
_______________________________________________________________

Dates Employed            From  To 

Companies Name       Companies Address 

City         State      Zip  

 
Job description / Duties    
 
 
Reason for leaving:

_____________________________________________________________________________

Dates Employed            From  To 

Companies Name       Companies Address 

City         State      Zip  

 
Job description / Duties    
 
 
Reason for leaving:

 

I herby certify that all the answers contained in this preliminary Employment Application are true and complete. I understand that any omission or misstatement on this application is cause for dismissal should I be employed. I authorize Fibre Optic Plus, Inc. to contact the schools persons and or companies named herein to verify the information I have given in addition to any other information they have regarding me.

Choosing the submit button will automatically e-mail your application to Don Ballseiper.

Please allow 3-5 business days for reply.

 

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