APPLICATION
FOR
EMPLOYMENT

Type or print in blue or black ink. Answer all questions which are applicable

PERSONAL INFORMATION

Last Name

First Name

Middle

Address

City

State / Zip

Phone

E-mail

EMPLOYMENT INFORMATION

Position for which you are applying ——————————————————————————————————————————————
Are you employed at the present time? ——————————————————————— If yes, please complete the information below
Employer’s Name: —————————————————————————————————————————————————————–
Employer’s Address: ————————————————————————————————————————————————————–
                                     ————————————————————————————————————————————————————-
1. How long have you been with this employer? ——————————————- Present Salary: ——————————————————-
2. If offered a position, when can you report for work? —————————————————————————————————————-
3. If hired can you show proof of your legal right to work in Tehran?                                                  Yes —————— No ———————
4. Have you ever been dismissed, or asked to resign from any position?                                            Yes —————— No ———————
5. Have you ever been convicted of a felony or a misdemeanor that resulted in imprisonment?    Yes —————— No ————————
(A yes answer to the above question does not necessarily disqualify an applicant from employment.)
If yes to number 4 or 5, please explain —————————————————————————————————————————————
———————————————————————————————————————————————————————————————

EDUCATION

Please list on the following lines all schools attended and any other pertinent information about your education.

School(s)

Subjects Studied (if applicable)

College (Including dates attended)

EMPLOYMENT EXPERIENCE (List most recent experience first)

Name & Address

Position(s) Held

Dates (Start-End)

REFERENCES

Name & Address (Include City, State, Zip)

Phone

Relationship

The following section is to be completed by an applicant for an OFFICE POSITION:

Can you type? ——————– How many words per minute?—————————
Computer Skills Macintosh ————————– PC —————————————–
Please provide computer and software knowledge below:

I certify that all statements made herein and on the enclosed resume are true and correct to the best of my knowledge. I authorize the investigation of all statements herein recorded. I release from liability all persons and organizations reporting information required by this application.