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Pre-Employment Questionnaire

Equal Opportunity Employer

* indicates a required field
Personal Information

Full Name:
*

Email:
*

Address:
*

City:
*

State:
*

ZIP:
*

Home Phone:
*

Daytime Phone:
*

Employment Desired

Position of Interest:


Date you can start:

Are you currently employed?:
YES
NO

If yes, may we inquire of your present employer?
YES
NO

Have you ever applied for employment with the Lansing Lugnuts?
YES
NO

If yes, what year did you start?

What position(s) did you hold?

Are you 18 years of age or older?
YES
NO

If no, how old are you?

Education

High School:

Location:

Years Attended:

Did you graduate?
YES
NO

 

College:

Location:

Years Attended:

Did you graduate?
YES
NO

 

Other:

Location:

Years Attended:

Did you graduate?
YES
NO

Employment History

Please list your last three employers, starting with your most current).

1. Month & Year:

1. Name & Address of Employer:

1. Position:

1. Reason for Leaving:

 

2. Month & Year:

2. Name & Address of Employer:

2. Position:

2. Reason for Leaving:

 

3. Month & Year:

3. Name & Address of Employer:

3. Position:

3. Reason for Leaving:

References

Please list the names of two persons not related to you, whom you have known at least one year.

1.Name:

1. Address:

1. Phone:

1. Years known:

 

2.Name:

2. Address:

2. Phone:

2. Years known:

Special Skills

Do you have any other experience, training, qualifications, or skills which you feel make you especially well suited for work with the Lansing Lugnuts?

How did you hear about employment with the Lansing Lugnuts?
Radio
Television
Newspaper
Poster
Friend
Other (please explain)

Can you perform the essential duties of the job in which you which to be employed, with or without accommodation?
With Accommodation
Without Accommodation

Have you ever been convicted of a crime of any kind?   
YES
NO

If yes, please explain:

(NOTE: No applicant will be denied employment solely on the grounds of a conviction of a criminal offense. However, the nature of the offense, the date of the offense, the surrounding circumstances, and the relevance of the offense to the position(s) applied for will be considered.)


 

Authorization

By submitting this application I hereby:
 
“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.”
 
“ 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.”
 
“ 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 foregoing unless it is in writing and signed by an authorized company representative.”