
Mukilteo
By The Sound
(Your CompanyName Here)
On-Line Employment Form
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Last name First MI |
For Personnel use only |
Date of application |
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Street address |
Type(s) of work desired Outlook/Exchange Programming and management |
Social Security number |
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City State ZIP |
Home telephone |
Work telephone |
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How were you referred to ___________? (Check only one.) |
A By your college |
B Advertisement |
C Employment agency |
D By an employee |
If so, give name: |
E Open house |
F Walk-in |
G Other |
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Please read carefully and complete by filling in the form fields, then save form fields only.
An Equal Opportunity Employer
We are an equal opportunity employer, and we do not and will not discriminate on the basis of race, religion, national origin, sex, age, handicap, marital status, or status as a disabled veteran. Information provided on this application will not be used for any discriminatory purpose.
Provide all information requested.
Your complete application form will be maintained in our active files for six (6) months from the date of application. You may submit a new application at any time.
Employment Record
Starting with present or most recent, list all previous employers. Include self-employment and summer and part-time jobs. If more space is required, please continue on a separate sheet. You may attach a resume, but complete this application as well.
Educational History
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School name |
Location (city, state) |
Major course or subject |
Dates attended From To |
Graduated Yes No |
Degree |
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High school Kent-Meridian |
Kent, WA |
College Prep |
9/44 |
6/58 |
X |
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Technical/trade (after high school) |
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College (list all attended) Reed College |
Portland, OR |
Physics |
9/58 |
6/62 |
X |
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BA |
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Rutgers-The State University |
New Brunswick, NJ |
Physics |
9/62 |
6/63 |
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X |
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California State College at Long Beach |
Long Beach, CA |
Physics, Anthropology |
? |
? |
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X |
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University of California Extension |
Los Angeles, CA |
Anthropology |
? |
? |
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X |
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University of California at Irvine |
Irvine, CA |
(anthropology) Social Science |
9/67 |
12/72 |
X |
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PhD |
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Other education/training |
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Outside Activities
(Exclude those indicating race, color, religion, sex, national origin, age, or handicap.)
Professional memberships, certificates, or licenses held
Member
of Microsoft’s MVP program –providing support in the Microsoft newsgroups. MVP Buddy is Abdias Ruiz at aruiz@MICROSOFT.com
See the document at the following URL for context: http://www.microsoft.com/presspass/features/1999/08-09pss.htm
Past and present civic or cultural activities — include offices held
Principal hobbies
Special Skills
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To be completed by
applicant for office/clerical work |
To be completed by
applicant for shop/plant work |
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Typing Yes Words per minute: No |
Type of machines operated |
Years experience |
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Dictation Yes Words per minute: No |
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Computer skills
Hardware Software |
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Please list other skills and/or equipment/language experience you have acquired |
List other shop/production skills |
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Served apprenticeship Yes Type: No |
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LANGUAGES:
Microsoft Basic for VB4
Microsoft VBA for VB4 and Office97 and Office2000 products
Clarion for the Windows Products
Clarion for the DOS Products
Lattice C for the Amiga
CDC COSY Assembler for the MP-60
IEC 1010 Assembler for the IEC-1010
MAAD
Various Forms of FORTRAN II to IV for the Univac 1108 and IBM 7094
SHORTRAN
The Assembly language for the Bendix G-15
Software:
Microsoft NT4/Back Office Small Business Server
Exchange
Outlook 2000
Word 2000
Front Page 2000
Visual Basic 6.0
Exposure to SQLServer7 and SQL Databases
Coming Soon: ASP
Microsoft Windows 95
Visual Basic 4.0
Clarion for Windows
Microsoft Windows 3.1x
Clarion For Windows
Microsoft DOS
Clarion Development System for DOS
Amiga Intuition
Lattice C
DEC RT-11
Assembler
FORTRAN IV
DEC IAS for the PDP-11/70
DEC (something) for the 11/34
HARDWARE:
PC-Compatibles (X86)
Amiga
Apple IIe
PDP-11/V03,V04
PDP-11/70
CDC MP-60
IEC-1010
PDP-11/34,45
PDP-10
Univac 1108
IBM-7094
Bendix G-15
Military Record
Branch of service From To
Present military affiliation:
None Reserve (active) Reserve (inactive)
Kinds of training and duty while in service
Professional/Work References
List two past supervisors and one person who is not related to you who have knowledge of your qualifications for the position for which you are applying.
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Name |
Title/relationship |
Address (street, city, state, ZIP code) |
Phone no. (include area code) |
Occupation |
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Dave ---- |
Line manager |
King County Government |
(206) xxx-xxxx |
(all telephone numbers taken from 1996 King County phone book) |
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Larry ---- |
Systems person/budget analyst |
King County Government |
(206) xxx-xxxx |
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Bob ---- |
Data aware facility inspector |
King County Government |
(206) xxx-xxxx |
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May we contact your present employer? Yes No |
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Wage or salary required $40K |
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Date available Now to present |
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I hereby certify that the
answers and other information on this application are true and correct and that
I understand any misrepre–sentation or omission of facts on my part will be
justification for separation from the company’s service, if employed. I
understand that my employment may be contingent upon receipt of an alien
registration number, verification of birth, and any other pertinent information
bearing upon my employment, and that my continued employment depends upon the
will of the company or myself.
August 11, 1999 Hollis
D. Paul
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Date Signature
If any of your educational or employment records are under other than the above name, please provide other names.