Application: Office Staff

Applicant Information

Name

Street

City

State

Zip Code

Phone

Date Available

Desired Salary

I am a US citizen.

I am authorized to work in the US.

I have worked for BTA before.

If you have worked here before, when?

I have been convicted of a felony.

If you have been convicted of a felony, please explain.

Education

High School

Name of School

Address

From

I graduated.

Diploma

College

Name of School

Address

From

I graduated.

Diploma

Other School

Name of School

Address

From

I graduated.

Diploma

References

Name

Company

Relationship

Phone

Address

Name

Company

Relationship

Phone

Address

Name

Company

Relationship

Phone

Address

Employment History

Employer #1

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for Leaving

You may contact my previous supervisor for a reference.

Employer #2

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for Leaving

You may contact my previous supervisor for a reference.

Employer #3

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for Leaving

You may contact my previous supervisor for a reference.

Military History

Branch

From

Rank at Discharge

Type of Discharge

If other than honorable, explain:

Signature

Date

Shipping

Careers

History

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Contact Us

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151 Riverside Drive
Fultonville, NY 12072

Phone: (518)853-5700