Please completely fill out each form.

Last Name   
First Name  Middle Name
Address 
State Zip
Telephone Numbers (home, cell, pager, etc.)

Email Address 
Social Security Number 
Position applied for
Date of application   
Have you ever filed an application with us before?
     Yes No If yes, when?
Have you ever been employed with us before?
Yes No If yes, what dates
Do any of your friends, relatives, or spouse work here? Yes No
         Name and relationship
How did you learn about us?
Best time to contact you for interview?
Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you a United States citizen? Yes No
Date you are available to start work
What is your desired salary range?
Are you available for:  Full time Part time Temporary
Hours and days you are available:

Are you currently on "lay-off" status and subject to recall? Yes No
Can you travel if a job requires it? Yes No  
Do you smoke? Yes No
Have you ever been accused of a crime? Yes No
Have you ever been convicted of a crime? Yes No
Have you ever plead guilty to a crime? Yes No

EDUCATION

WORK EXPERIENCE

Describe any specialized training, apprenticeship, skills,
and extra-curricular activities:

Describe any job-related training received in the United States military:

List professional, trade, business, or civic activities and offices held:

Other qualifications:

Office equipment operated:

Computer programs operated:

References:    
Do not include family members or past supervisors

Tyner Law Firm, P.A. considers applicants for all positions without regard to
 race, color, religion, creed, gender, national origin, age, disability, 
marital or veteran status, or any other legally protected status.

Applicant's Statement:

I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at employment decisions and this authorization is valid until cancelled in writing by applicant.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at arty time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization

In the event of employment, I understand that false or misleading information given in my application or interviews) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the employer.