Home Online Fillable Forms Part Time Employment Application Part Time Employment Application City of Grosse Pointe17147 Maumee AvenueGrosse Point, MI48230313-885-5800 It is the policy of the company to provide equal opportunity with regard to all terms and conditions of employment. The company complies with federal and state laws prohibiting discrimination on the basis of race, color, religion, creed, national origin, gender, disability, veteran status, age or any other protected characteristic. Name:Phone:Address:City/State/Zip:Position Applied For:Shift Preferred: --Select One-- 1 2 3 4 Any Special training or skills (languages, machine operation, etc.) that would benefit you in the job for which you are applying:Would you accept full-time work?: --Select One-- Yes No Would you accept part-time work?: --Select One-- Yes No On what date would you be available for work?:dd/mm/yyyyHave you ever been employed here before?: --Select One-- Yes No Dates: From mm/dd/yyyy - To mm/dd/yyyyDo you have a legal right to be employed in the U.S.? --Select One-- Yes (proof required if hired) No If you are under 18, can you provide a work permit if required?: --Select One-- Yes No Educational BackgroundGrammar SchoolName and Location:Course of Study:Did you graduate?: --Select One-- Yes No Degree or Diploma:High SchoolName and Location:Course of Study:Did you graduate?: --Select One-- Yes No Degree or Diploma:CollegeName and Location:Course of Study:Did you graduate?: --Select One-- Yes No Degree or Diploma:Graduate SchoolName and Location:Course of Study:Did you graduate?: --Select One-- Yes No Degree or Diploma:Vocational or other trainingName and Location:Course of Study:Did you graduate?: --Select One-- Yes No Degree or Diploma:Continuing Education: Previous Employers and AddressesCheck the box by the employer(s) you do not wish us to contact. List the most recent first. Company Name:Contact name:Address:Dates of employment:From: mm/dd/yyyy - To: mm/dd/yyyyPosition:Reason for leaving: Company Name:Contact name:Address:Dates of employment:From: mm/dd/yyyy - To: mm/dd/yyyyPosition:Reason for leaving: Company Name:Contact name:Address:Dates of employment:From: mm/dd/yyyy - To: mm/dd/yyyyPosition:Reason for leaving: Company Name:Contact name:Address:Dates of employment:From: mm/dd/yyyy - To: mm/dd/yyyyPosition:Reason for leaving: I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. Applicant’s Signature:Date: dd/mm/yyyy