GAMERS APPLICATION FOR EMPLOYMENT
PRE-EMPLOYMENT QUESTIONNAIRE
EQUAL OPPORTUNITY EMPLOYER
DATE:
Last Name: First Name: Middle Initial:
Are you over 16? Email Address:
Present Address:
City: State: Zip Code:
Phone Number ###-###-####: How did you hear about this job?
Do you know anyone currently employed by Gamers? If so, who?
EMPLOYMENT DESIRED
Position: Date you can start: Salary:
Are you currently employed? If so, may we inquire of your present employer?
Have you ever applied at Gamers before? Where? When?
EDUCATION HISTORY
Name and Location of School Years attended Did you graduate? Subjects studied
High School
Post-Secondary School
Post-Secondary School
GENERAL INFORMATION
Why should we hire you?
U.S. Military or Naval service? Rank:
Have you ever been convicted of a felony? If yes, explain:
FORMER EMPLOYERS (list below your last five employers, starting with the most recent)
Date, Month, and Year Name of Employer Contact Person Phone Number Salary Reason for leaving
Job Title Position Duties
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
REFERENCES (give the names of three persons not related to you, whom you have known at least one year)
Name Phone Number Business Years Known
AVAILABILITY (please select your level of availability such as morning, afternoon, evening, after school, or not available)
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
AUTHORIZATION

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

By typing my name below I am providing my signature on this electronic document.

Date: Signature: