Online Employment Application

Personal

*First Name:
*Last Name:
*Email:
*Address:
*City:
*State:  *Postal Code:
*Phone:
Alt. Phone:

Work Interest

Position Applying for:

OR

*Area(s) of interest
*Work Type
*Date Available  
*Are you currently authorized to work
in the U.S. on a full-time basis?
Yes No
*Have you ever been previously
employed by Dixie Chopper?
Yes No
If yes, when?From:  
 To:  
*Referral Service/Source:
Referred by:

Education

High School/Vocational School

*Name/Location of School:
*Did you graduate? Yes No GED
*Major/Subjects Studied

Trade/Business/Correspondence School

Name/Location of School:
Did you graduate? Yes No
Degree/Certificate Earned: Certificate
Other:
Major/Subjects Studied

College

Name/Location of School:
Did you graduate? Yes No
Degree/Certificate Earned: Associates
Bachelors
Post Graduate
Other:
Major/Subjects Studied

Military History

*Have you served in the US Military? Yes No
If yes, when?From:  
 To:  
List any special skills or training as a
result of service in the military

Other Personal

*Have you ever been convicted of a Felony?
(Do not disclose sealed or expunged records of
convictions or arrests.)
Yes No
If yes explain:
*If considered for employment will
you authorize Dixie Chopper to
conduct a criminal background check?
Yes No

Employment History

List in reverse chronological order with most recent employer first

Employer

Employer:
Supervisor:
City:
State:
Phone:
Employment Dates:From:  
 To:  
Position Held:
Rate of Pay:
Job Duties:
Reason for Leaving:
OK to contact? Yes No

Employer

Employer:
Supervisor:
City:
State:
Phone:
Employment Dates:From:  
 To:  
Position Held:
Rate of Pay:
Job Duties:
Reason for Leaving:
OK to contact? Yes No

Employer

Employer:
Supervisor:
City:
State:
Phone:
Employment Dates:From:  
 To:  
Position Held:
Rate of Pay:
Job Duties:
Reason for Leaving:
OK to contact? Yes No

Employer

Employer:
Supervisor:
City:
State:
Phone:
Employment Dates:From:  
 To:  
Position Held:
Rate of Pay:
Job Duties:
Reason for Leaving:
OK to contact? Yes No

Employer

Employer:
Supervisor:
City:
State:
Phone:
Employment Dates:From:  
 To:  
Position Held:
Rate of Pay:
Job Duties:
Reason for Leaving:
OK to contact? Yes No

Attachments

Attachments accepted in PDF format only

Resumé
Cover Letter
Image Code (Audio)

*Enter the above letters: