Magnatech Business Systems, Inc. 'The Multi User System Specialists' http://www.magnatechonline.com 535 South Broadway, Suite #215-B Hicksville, NY 11801-5029 Tel: (516) 931-4444 Fax: (516) 931-1264 JOB APPLICATION DATE:___/___/___ NAME: __________________________________ SOC. SEC.#: ____-___-____ ADDRESS:_________________________________________________________________ PHONE #:(Days) (____)_____________ (Eves)(____)_________________ POSITION DESIRED: _______________________ SALARY DESIRED: ___________ AVAILABLE TO BEGIN: / / . Days/Hrs Available: _________________ EMAIL ADDRESS: __________________________________ Use Of A Car? Y / N EDUCATION: SCHOOL AREA OF STUDY From/To DEGREE +-----------------------------------------------------------------------+ | | | | | | +-----------------------------------------------------------------------+ | | | | | | +-----------------------------------------------------------------------+ | | | | | | +-----------------------------------------------------------------------+ PREVIOUS EMPLOYMENT & EXPERIENCE: (list from most recent first) +----------+-----------------+------------+--------+------------------+--------+ | DATES | COMPANY NAME | CONTACT / | | POSITION / | REASON | | From/To | AND ADDRESS | PHONE # | SALARY | RESPONSIBILITIES | LEFT | | | | | | | | +----------+-----------------+------------+--------+------------------+--------+ | | | | | | | | / / | | | | | | | | | | | | | | / / | | | | | | +----------+-----------------+------------+--------+------------------+--------+ | | | | | | | | / / | | | | | | | | | | | | | | / / | | | | | | +----------+-----------------+------------+--------+------------------+--------+ | | | | | | | | / / | | | | | | | | | | | | | | / / | | | | | | +----------+-----------------+------------+--------+------------------+--------+ | | | | | | | | / / | | | | | | | | | | | | | | / / | | | | | | +----------+-----------------+------------+--------+------------------+--------+ REFERENCES - Name Tel # Relation YRS KNOWN 1.Personal :________________________ ___________ _________ _________ 2.Professional:________________________ ___________ _________ _________ 3.Professional:________________________ ___________ _________ _________ Have you ever been convicted of a crime? Y / N . If Yes, please explain: FOR COMPUTER-RELATED EMPLOYMENT, PLEASE COMPLETE THE FOLLOWING QUESTIONS. Proficiency For each of the following categories, indicate Knowledge or Programming ability in each of your answers by annotating with a 'K' or 'P' next to each entry. Operating Systems:____________________________________________________________ ______________________________________________________________________________ Hardware Platforms:___________________________________________________________ ______________________________________________________________________________ Database/4GL Languages:_______________________________________________________ ______________________________________________________________________________ Computer Languages:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Other Software Packages:______________________________________________________ ______________________________________________________________________________ Software/Hardware Technologies & Theories:____________________________________ ______________________________________________________________________________ Relevant Coursework:__________________________________________________________ ______________________________________________________________________________ Relevant Projects/Business Background (under employment or school):____________ ______________________________________________________________________________ ______________________________________________________________________________ Please indicate, in 50-100 words, comments about yourself and how you would benefit Magnatech Business Systems, Inc. in your employment: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ I, the undersigned, do hereby state that any/all information on my employment application is correct. I further grant permission to Magnatech Business Systems, Inc. the right to verify any information claimed on said application. _________________________________ ______________________________ PRINT NAME SIGNATURE Magnatech Business Systems, Inc. is an equal opportunity employer. Any information regarding age, sex, religious affiliation, race, creed, color, and nationality of applicant will not be used as factor in consideration for hire.