Employment

Applicant Information

*** Application must completed in full in order to be considered for a position at Bay State*****

Are you a citizen of the United States?

If no, are you authorized to work in the U.S.?

Have you ever worked for this company?

Have you ever been convicted of a felony?

Availability to Work

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Education

Did you graduate?

Did you graduate?

Did you graduate?

Previous Employment

May we contact your previous supervisor for a reference

May we contact your previous supervisor for a reference

References

Please list two professional references

Military Service

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or this inter- view may result in my release.