Employment Opportunities

DeGoede Brothers, LLC
5816 162nd Ave. E.
Sumner, WA 98409

Phone: (253) 863-0488
FAX: (253) 863-8297

Your Name:     Social Security#:
Present Address:
Permanent Address:
Email Address:
Phone Number:                Are you 18 yrs or older? yesno
Are you either a U.S. Citizen or an alien authorized to work in the United States? yesno
Position applied for: /   Salary desired:
Earliest date you can start:    Are you employed now: yesno
If you are presently employed can we contact your employer: yesno
Have you ever applied to this company before: yesno   If yes, when:
Have you ever worked for this company before: yesno   If yes, when:

Education Background Name & Location Course of Study Degree Earned

High School

College/Tech/Business

Graduate School

General subjects of special study or research work:
U.S. Military Service:    Rank:
Are you presently in the National Guard or Reserves: yesno
What foreign languages do you speak fluently:   Read:   Write:

Employment History
1. Present or last employment: Company:    Phone:
Address:
Nature of business:    Dept.
Number of People Supervised:    Dates Employed: to    Rate of Pay:
Immediate supervisor:    Name of supervisor's boss:
What were you major job functions? Itemize:
What did you like most about this job:
What did you like least about this job:
State reasons for leaving or considering change:

2. Next previous employment: Company:    Phone:
Address:
Nature of business:    Dept.
Number of People Supervised:    Dates Employed: to    Rate of Pay:
Immediate supervisor:    Name of supervisor's boss:
What were you major job functions? Itemize:
What did you like most about this job:
What did you like least about this job:
State reasons for leaving or considering change:

3. Next previous employment: Company:    Phone:
Address:
Nature of business:    Dept.
Number of People Supervised:    Dates Employed: to    Rate of Pay:
Immediate supervisor:    Name of supervisor's boss:
What were you major job functions? Itemize:
What did you like most about this job:
What did you like least about this job:
State reasons for leaving or considering change:

Indicate any of the above listed employers that you do not wish contacted:

References: give names of three professional references whom you have known at least one year:

Name Address Company Telephone Years Known

Do you smoke: yesno

RELEASE: I understand the need for a consent to any reference checks, drug screening
or other background checks as may be deemed necessary by the employer.

Education Background	Name & Location	Course of Study	Degree Earned
High School
College/Tech/Business
Graduate School