EMPLOYMENT APPLICATION
Calhoun County Landfill
Suite 103
1702 Noble Street
Anniston, AL 36201
Last Name
First Name Middle Name
1) Job Appling For:
2) Your Name:
3) Address:
No. And Street
RD or PO Box APT. No.
4) How long have you lived at this address?
Years: Months:
City
State Abr. ZIP Code
5) Your Telephone Number:
Home Work
6) Social Security Number
7) Have you ever been convicted of any offense other
than a minor traffic violation?
Yes No
Conviction is not necessarily disqualifying. Give facts and
dates of your conviction(s) in Space 8.
8) Use this space to explain any items in Spaces 1-7:
9) EDUCATION
A) Did you graduate from high school?
Month
Year
Highest Grade Completed
Yes
No
B) If you have a high school equivalency certificate, give year and place the certificate was granted:
Year
Place Granted
C) Give last high school, grade school or trade school you attended:
Name of School Location Dates Attended Course
D) List any colleges, business schools or technical schools you attended:
Name of School
Location
Course or Major
Dates Attended
Degree or Certificate Received
E) Other training (special courses, work training programs, armed forces training). Give name and location where training was given, certificate (if any), dates
attended, subject of training, number of hours weekly, and other details related to the job for which you are applying:
(See Next Page)
Fill in form using
Acrobat Reader or
print and
complete
in ink or on a
typewriter.
Voice Number: (256) 236-2411
Fax Number: (256) 241-2098
Full Time ____ Part Time ____ Seasonal _____ Job Title: