WABG - TV
APPLICATION FOR EMPLOYMENT
An Equal Opportunity Employer
We do not discriminate on the basis of race, color, race, religion, national origin, sex, age, or disability. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.
Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. Use blank paper if you do not have enough room on this application. PLEASE PRINT, except for signature on back of application. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.
Job applied for							Today's Date
What type of employment?				Full-time		Part-time		Temporary
Do you have the ability to perform the essential functions of this position?
Salary desired	$				per
When could you start work?
Where did you learn of this position?
Last Name			First Name					Middle Name
Present Street Address			City				State		Zip Code
Home Phone	(           )					Bus. Phone	(           )
Are you 18 years of age or older?				Yes		No
		(If you are hired, you may be required to submit proof of age.)
If hired, can you furnish proof you are eligible to work in the U.S.?								Yes		No
Have you ever applied here before?				Yes		No
	If yes, when?
Have you ever been convicted of any law violation?						Yes		No
	If yes, give details
	What was the offense?
	Date of conviction and sentence?
	(A "yes" answer does not automatically disqualify you from employment, since the nature of the offense, date, and the job for which you are applying will be considered.)
Are you willing to relocate?				Yes		No
Are you willing to travel?				Yes		No		% of time
Are you now or do you expect to be engaged in any other business or employment?
				Yes		No
	If yes, explain

WABG - TV
APPLICATION FOR EMPLOYMENT
Education: List Name & Address of Schools
High School or GED
		Graduate		Yes		No
College
		Graduate		Yes		No
Subjects Studied
Vocattional or Technical
Subjects Studied

WABG - TV
APPLICATION FOR EMPLOYMENT
Special Skills
What skills or additional training do you have that are related to the job for which you are applying?
Computer experience?				Yes		No	Yrs.
Software	(list software you are experienced in)
Are you bilingual?				Yes		No
	If yes, specify languages
If your position requires that you drive, do you have a valid driver's license?
				Yes		No
	Driver's License Number
	State Licensed in
	Have you had your license been suspended or revoked in the last 3 years?
				Yes		No
	If yes, give details
List professional, trade, business, or civic activities and offices held.
(Exclude labor organizations and memberships which reveal race, color, religion, national origin, sex, age, disability, or other protected status.)
List any governmental or professional licenses or accredication held:

WABG - TV
APPLICATION FOR EMPLOYMENT
Work History
List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any period of unemployment. If self-employed, give firm name and supply business references.
	From					To
		MONTH		YEAR			MONTH		YEAR
Name of Employer						Title
Supervisor
Address						Pay
City, State, ZIP							START		FINAL
Telephone
Duties
	From					To
		MONTH		YEAR			MONTH		YEAR
Name of Employer						Title
Supervisor
Address						Pay
City, State, ZIP							START		FINAL
Telephone
Duties
	From					To
		MONTH		YEAR			MONTH		YEAR
Name of Employer						Title
Supervisor
Address						Pay
City, State, ZIP							START		FINAL
Telephone
Duties