Industry West raises the world’s creative quotient in an era of perpetual blur between the

places people work, play, and live.

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION
DATE Of APPLICATION:______________

Name:
______________________________________________________________________

Address:
______________________________________________________________________

Contact Information:
______(_____)________________(____)_______________________________

Home Telephone________________________________________________________

Mobile Telephone________________________________________________________

Email__________________________________________________________________

How did you learn about our company?______________________________________

POSITION SOUGHT: _____________________________________________________

Desired Pay Range: ________________

Are you currently employed? _________________

Available Start Date:______________
Are you eligible to work in the US? _______________

Work availability: Part time / Full time

Available work hours: ________________

COMPUTER SKILLS
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________
EDUCATION

Name and Location of Schools attended:

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Graduate Yes/ NO

If yes, Degree______________________________________________

Major / Subjects of Study_________________________________________________

High School
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

College or University
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Specialized Training, Trade School, etc…

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Other Education

Please list your areas of highest proficiency, special skills or other items that may
contribute to your abilities in performing the above mentioned position.
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________
PREVIOUS EXPERIENCE:

Please list beginning from most recent

*Dates Employed
________________________________________________________

Company Name ________________________________________________________

Location ______________________________________________________________

Role/Title _____________________________________________________________
Job notes, tasks performed and reason for leaving:
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

*Dates Employed
________________________________________________________

Company Name ________________________________________________________

Location ______________________________________________________________

Role/Title _____________________________________________________________
Job notes, tasks performed and reason for leaving:
______________________________________________________________________

______________________________________________________________________
______________________________________________________________________

______________________________________________________________________

*Dates Employed
________________________________________________________

Company Name ________________________________________________________

Location ______________________________________________________________

Role/Title _____________________________________________________________
Job notes, tasks performed and reason for leaving:
______________________________________________________________________

______________________________________________________________________

_____________________________________________________________________

*Dates Employed
________________________________________________________

Company Name ________________________________________________________

Location ______________________________________________________________

Role/Title _____________________________________________________________
Job notes, tasks performed and reason for leaving:
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

*Dates Employed
________________________________________________________

Company Name ________________________________________________________

Location ______________________________________________________________

Role/Title _____________________________________________________________
Job notes, tasks performed and reason for leaving:
______________________________________________________________________
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

*Dates Employed
________________________________________________________

Company Name ________________________________________________________

Location ______________________________________________________________

Role/Title _____________________________________________________________
Job notes, tasks performed and reason for leaving:
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

*Dates Employed
________________________________________________________

Company Name ________________________________________________________

Location ______________________________________________________________

Role/Title _____________________________________________________________
Job notes, tasks performed and reason for leaving:
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Industry West provides equal employment opportunities to all employees and applicants for
employment and prohibits discrimination and harassment of any type without regard to
race, color, religion, age, sex, national origin, disability status, genetics, protected veteran
status, sexual orientation, gender identity or expression, or any other characteristic
protected by federal, state or local laws. In addition, Industry West will provide reasonable
accommodations for qualified individuals with disabilities.
 I, __________________________, attest that the information contained on the
application is true and accurate.

Applicant Signature: ___________________________________________________