Application For Employment
We are an equal opportunity employer

Personal Information
Last Name First Name
e-mail address Social Security Number
(SSAN)
Present Address City
State Zip Code
Phone Number Are you 18 years or older? Yes ...No
Permanent Address
(if different from above)		 City
State Zip Code
CA Drivers License No. Is your license valid? Yes ...No
Number of traffic violations
within the last 2 years		 Number of traffic accidents
within the last 2 years
Education
Name and location
of school		 No. yrs.
attended		 Did you graduate? Subjects Studied
High School Yes   No
College Yes   No
Trade, business or other Yes   No
General   
Subjects of special study or research:
 		Special Skills:
Activities and Hobbies:
 		Comments
(Include explanation of
any gaps in employment):
Employment
Dates of Employment
(begin with most recent) 		Name, address, phone number of employer Salary Posititon Reason for Leaving
From:
To:
From:
To:
From:
To:

I certify that all the information submitted by me on this application is true and complete, and if any false information, omissions, or misrepresentations are discovered, my application may be rejected. If I am already employed, my employment may be terminated.

By placing my initials in this box I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

GENERAL ENGINEERING CONTRACTOR LICENSE 506016
James Sommerville, Inc. - 21925 Rosehart Way - Salinas, CA 93908
Phone: (831) 751-0702 FAX: (831) 751-3951 e-mail: Info@jsi.com

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© 2003 James Sommerville, Inc.