Employment Information

EMPLOYMENT INFORMATION FORM

Date: _______________________________
Employer: ___________________________
Address: ____________________________
_____________________________________
Telephone: _______________________
Email Address: _______________________

Nature of business: ____________________________
Position: ____________________________
Employee qualifications_________________________________________ Wages or salary $________________ per __________________________ Employment Type: _____ Temporary ______ Permanent Hours ________ to _______ Days ___________ to __________ Benefits: ____________________________
Reference: ____________________________
Additional Notes: ___________________________________