- Link2CITY Inc

Pre-Employment Questionnaire

An Equal Opportunity Employer

IMPORTANT - ALL FIELDS ARE REQUIRED. PLACE A 0 (ZERO) FOR INAPPLICABLE FIELDS

Desired Employment

Position	Desired Income	Date you can Start

Former Employers

List below last three employers, starting with PRESENT/ most recent

Name of Present Employer

Address

City	State	Zip

Starting Date	Leaving Date	Job Title

Monthly Salary	Monthly Commission/ Bonus	May we contact your supervisor?
		YesNo
Name of Supervisor	Title	Phone

Description of Work:

Reason for Leaving:

Name of Previous Employer

Address

City	State	Zip

Starting Date	Leaving Date	Job Title

Monthly Salary	Monthly Commission/ Bonus	May we contact your supervisor?
		YesNo
Name of Supervisor	Title	Phone

Description of Work:

Reason for Leaving:

Name of Previous Employer

Address

City	State	Zip

Starting Date	Leaving Date	Job Title

Monthly Salary	Monthly Commission/ Bonus	May we contact your supervisor?
		YesNo
Name of Supervisor	Title	Phone

Description of Work:

Reason for Leaving:

Have you been convicted of a felony within the last 5 years?

YesNo

If yes, explain (will not necessarily exclude you from consideration)

Additional comments

Employment Application