GEX, INC. APPLICATION FOR EMPLOYMENT
About You
Position Applied For
Date of Application (mm/dd/yy)
How Did You Learn About Us
Advertisement Friend On-line
Employment Agency Relative Other
First Name
 Last Name
 Middle Name
Address
 City
 State
 Zip
Telephone Number
 E-mail
  
If you are under 18 years of age, can you provide required proof
of your eligibility to work?		 Yes No
Have you ever filed an application with us before? Yes No
If yes, give date
Have you ever been employed with us before? Yes No
If yes, give date
Are you currently employed? Yes No
May we contact your employer? Yes No
Are you prevented from lawfully becoming employed in this
country because of visa or immigration status?
  (Proof of citizenship or immigration status will be required
upon employment.)
Yes No
On what date would you be available to work?
Are you available to work:
Are you currently on "layoff" status and subject to recall? Yes No
Have you been convicted of a felony within the last 7 years?
  (Conviction will not necessarily disqualify an applicant
from employment.)
Yes No
If yes, please explain  
Education
  Elementary School High School Undergraduate
College / University 		Graduate Professional
School name and location
Years Completed
Diploma / Degree
Describe Course of Study
References
Give name, address and telephone number of three references who are not related to you and are not previous employers
1. Name
 Address
 Telephone #
2. Name
 Address
 Telephone #
3. Name
 Address
 Telephone #

Have you ever had any job-related training in the United States military Yes No
Are you physically or otherwise unable to perform the duties of the job
for which you are applying		 Yes No

Employment Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, handicap or other protected status.
1.
Employer

Length of Service

Hourly Rate/Salary
Starting
 Final

 

Work Performed
Address
Telephone #
Job Title
Reason for Leaving
2.
Employer

Length of Service

Hourly Rate/Salary
Starting
 Final

 

Work Performed
Address
Telephone #
Job Title
Reason for Leaving
3.
Employer

Length of Service

Hourly Rate/Salary
Starting
 Final

 

Work Performed
Address
Telephone #
Job Title
Reason for Leaving
4.
Employer

Length of Service

Hourly Rate/Salary
Starting
 Final

 

Work Performed
Address
Telephone #
Job Title
Reason for Leaving

Special Skills and Qualifications
Summarize any special job-related skills and qualifications acquired from employment or other experience


Application Experience (Leave Blank if None)
Application Version Platform Experience
QuarkXpress
InDesign
FrameMaker
PageMaker
Microsoft Word
Microsoft Excel
Freehand
Illustrator
Photoshop
Other (please list)


Programming Experience (Leave Blank if None)
Application/Language Version Experience
Visual Basic
C++
Java
HTML
XML
Other (please list)


Proofreading Experience (Leave Blank if None)
  Experience
Text Proofing
Spec Proofing
Editorial Work (Explain)

PHONE: 603-870-9292 | FAX: 603-870-9199 TWO INDUSTRIAL WAY ATKINSON, NH 03811