Job Opening Form

Name

First Last

Date of Birth

Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone

Email

Position that you are applying for:

Salary desired

Why do you want to work in radio?

Employer:

Telephone

Address

Street Address City State / Province / Region ZIP / Postal Code

From:

To:

Job Title

Salary

What were your duties?

What did you like best about this job?

Why did you leave?

Employer:

Telephone

Address

Street Address City State / Province / Region ZIP / Postal Code

From:

To:

Supervisor

Job Title

Salary

What were your duties?

What did you like best about this job?

Why did you leave?

Employer:

Telephone

Address

Street Address City State / Province / Region ZIP / Postal Code

From:

To:

Supervisor

Job Title

Salary

What were your duties?

What did you like best about this job?

Why did you leave?

High School

Name of School/Location

Completed?

Name of School/Location

Dates Attended

Degree/Major

Completed?

Other

Name of School/Location

Dates Attended

Degree/Major

Completed?

Other

Name of School/Location

Dates Attended

Degree/Major

Completed?

What is the most important thing you have ever learned and how has it changed your life?

What one thing makes you stand out over all the rest? Why should we hire you rather than Applicant X?

What are your greatest strengths - the things about you that cause you the greatest pride?

What are your greatest wakenesses, the things about yourself that you could benefit the most from working to improve (It's okay to have weakenesses!)

Name your favorite type of music:

Are you seeking full-time or part-time employment?

If hired, when would you be able to start?

Are you a U.S. citizen/national? If no, are you eligible for employment in the U.S.?

Have you ever been convicted of felony? If yes, please give reason and date of conviction

Please indicate hours you could work on a regular basis each day of the week, including weekends:

I get along well with most people

Yes
No

Last Question: What ONE word describes you best and why did you choose that word?

By signing this application, I certify that everything in it (and accompanying resume, if any) is true to the best of my knowledge. I understand that if I falsify or omit any information it will disqualify me from further consideration and will terminate my employment if discovered at a later date. I understand that my employment can be terminated at any point, with or without cause, by either the company or myself. I authorize persons, schools, current and previous employers and organizations named in this application to provide relevant information that may be required to arrive at an employment decision. I understand that filling out this application does not indicate that there is a position open and does not obligate Withers Broadcasting to hire me. If hired, I agree to abide by company work rules, policies and procedures and recognize that company retains the right to revise policies or procedures, in whole or part, at any time. I understand that Withers Broadcasting is an Equal Opportunity Employer and does not discriminate against any employee or applicant because of age, religion, race, sex, color, national origin, disability, non job-related handicap, or because they are a disabled veteran. if you believe your equal employment rights have been violated, you may contact the Federal Communications Commission, the Equal Employment Opportunity Commission or the appropriate local EEO agency. TYPE YOUR NAME AND TODAY'S DATE.*

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