Monroe
ounty
nterprises
EMPLOYMENT APPLICATION
Provide all information requested by printing in ink or keying. Use the tab key to move through the document.
GENERAL INFORMATION
Name (Last)
(First)
Address (Mailing Address)
(City)
(Middle
Initial)
(Stat
e)
E-mail Address
(Zip)
Home Telephone
() -
Cell Phone
() -
POSITION
Will Accept:
Part-Time
Position or Type of Employment Desired
Have you ever been employed at the Monroe County Enterprises before?
Yes
No
Are you able to perform the essential functions of the job you are applying
for, with or without reasonable accommodation?
Yes
No
Full-Time
Date Available:
Salary Desired
$___________ / monthly
EDUCATION AND TRAINING
School or
Institution
Name and Address of School
Major/Study
Beginning
& Ending
Year
Degree
Mary Persons High School
High School
College Name
College Address
College City &
State
Special Abilities and Skills (3 tasks from CIS)
________________ Pathway
Extracurricular Activities (at least 2 areas of
Present Community and Professional
Affiliations (at least 2)
interest/hobby)
2016-2020
2020-2024
BA
Professional Certificates or Licenses Held (Yes
or No)
Languages Read, Written or Spoken Fluently Other Than English
REFERENCES
List below names and addresses of persons who are qualified to answer questions concerning your fitness for the
position(s) you seek other than those listed in your credential file. (3 classmates from THIS class. Get a sheet of
paper and Go to the L Drive folder REFERENCES jot down the information and come back to this
document and type it in.)
Name
Position
Address
AN EQUAL OPPORTUNITY EMPLOYER
Telephone
WORK EXPERIENCEMost recent first, include voluntary work and military experience
Employer
Address
Job Title
Specific Duties (Maximum 350 characters)
lifting heavy objects
assembling products
budget reports
taking pictures
filing
washing/cleaning vehicles
typing
copying
running errands
recording
assisting the director/boss
customer service
driving/delivering
answering phone
data entry
Telephone Number () -
Number Employees Supervised 2
operating heavy machinery
faxing
cleaning
supervising 1 / 2
stocking
organizing
Reason For Leaving Graduated College
inventory control
cutting/washing hair
Hours Per Week
15-20
Last Salary
$____/hour
handling various reports
repairing equipment
ordering/buying supplies
counseling
From (Month/Year)
October/2022
To (Month/Year)
March/2024
Supervisor
S. Dorsey
May We Contact This Employer?
No
Yes
I certify the information contained in this application is true, correct, and complete. I understand that, if
employed, false statements reported on this application may be considered sufficient cause for dismissal.
You will enter an electronic signature. Click in the gray box beside Signature of Applicant select any
script or cursive style font type your first and last name (capitalize the first letter of each).
Signature of Applicant:
Date:
AN EQUAL OPPORTUNITY EMPLOYER