Full Name:
For what position are you applying?
*Transfer will not be considered unless employee has worked three months in present position.
Present Job Title:
Are you over 18? Yes No
If no, indicate age:
List any known reason why you may be physically unable to perform consistently and promptly any duties of the position for which you are applying:
How many hours are you interested in working weekly? 10-20 20-30 30-40
Summer only? Yes No
If yes, can you work through Labor Day? Yes No
Are you presently attending school?
Do you plan to attend school in the future? Yes No
When?
Where?
Specify general hours available: 7 am-5 pm 12 noon-9 pm 4 pm-11 pm 10 pm-7 am
Are there any activities that would affect your working hours?
If yes, explain:
Briefly state your reason(s) for wanting to transfer to another position:
Signature of Employee: (Please type name)
Signature of Present Supervisor: (Please type name)
