Job Application Form

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Job Application Form

A job application form is used to collect the details of an applicant interested in employment. It provides hiring employers with an overview of the applicant’s education, work history, and references. This document also lets the employer know if the applicant will consent to a background check if asked later on in the application process.

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Last updated July 5th, 2025

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A job application form is used to collect the details of an applicant interested in employment. It provides hiring employers with an overview of the applicant’s education, work history, and references. This document also lets the employer know if the applicant will consent to a background check if asked later on in the application process.

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Job Application Restrictions

Many states have legislation (such as California’s “Fair Chance Act”) that prohibits employers from requesting an applicant’s criminal or salary history on a job application.[1] Employers are advised to check regional and industry-specific restrictions on the information they can collect in the job application process.

Under the Code of Federal Regulations, employers must keep job applications in their filings for at least one year.[2]

Job Application Laws – By State

View State Requirements
The following is a list of the state restrictions for private employers regarding their ability to collect salary and criminal history during the application process:
State Criminal History Salary History
AL No statute. No statute.
AK No statute. No statute.
AZ No statute. No statute.
AR No statute. No statute.
CA[3] Not permitted for employers w/ 5+ employees. X
CO[4] X X
CT[5] X X
DE[6] No statute. X
FL No statute. No statute.
GA No statute. No statute.
HI[7] X X
ID No statute. No statute.
IL[8] Not permitted for employers with 15+ employees. X
IN No statute. No statute.
IA No statute. No statute.
KS No statute. No statute.
KY No statute. No statute.
LA No statute. No statute.
ME[9] X X
MD[10] No statute. X
MA[11] No statute. X
MI No statute. No statute.
MN[12] X No statute.
MS No statute. No statute.
MO No statute. No statute.
MT No statute. No statute.
NE No statute. No statute.
NV No statute. No statute.
NH No statute. No statute.
NJ[13] Not permitted for employers with 15+ employees. X
NM No statute. No statute.
NY[14] Not permitted to seek information on arrest history (conviction history allowed).
In NYC, not permitted for employers with 4+ employees.		 X
NC No statute. No statute.
ND No statute. No statute.
OH No statute. No statute.
OK No statute. No statute.
OR[15] No statute. X
PA No statute. No statute.
RI[16] X No statute.
SC No statute. No statute.
SD No statute. No statute.
TN No statute. No statute.
TX No statute. No statute.
UT No statute. No statute.
VA No statute. No statute.
VT[17] X No statute.
WA[18] X X
WI No statute. No statute.
WV No statute. No statute.
WY No statute. No statute.

Employment/Job Application (No Conviction/Salary History) –  Collects an applicant’s information and references, but does not inquire about previous wages or convictions.

Sample

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EMPLOYMENT/JOB APPLICATION

PERSONAL INFORMATION

Full Name: [APPLICANT NAME] Date: [MM/DD/YYYY]
Address: [APPLICANT ADDRESS] E-mail: [APPLICANT EMAIL]
Phone: [APPLICANT PHONE] Social Security Number (SSN): [SIN #]
Date Available: [MM/DD/YYYY] Desired Pay: $[AMOUNT] ☐ Hour ☐ Salary
Position Desired: [POSITION] Employment Desired: ☐ Full-time ☐ Part-time ☐ Seasonal

EMPLOYMENT ELIGIBILITY

Are you legally eligible to work in the U.S? ☐ Yes ☐ No
Have you ever worked for this employer? ☐ Yes* ☐ No
*If yes, write the start and end dates: [MM/DD/YYYY][MM/DD/YYYY]
Have you ever been convicted of a felony? ☐ Yes* ☐ No *Explain: [EXPLAIN FELONY]

EDUCATION

High School: [HIGH SCHOOL NAME] City/State: [CITY/STATE]
From: [MM/DD/YYYY] To: [MM/DD/YYYY] Graduate? ☐ Yes ☐ No

College: [COLLEGE NAME] City/State: [CITY/STATE] Period: [MM/DD/YYYY][MM/DD/YYYY]
Graduate? ☐ Yes ☐ No Degree: [FIELD OF STUDY]

Other: [INSTITUTION NAME] City/State: [CITY/STATE]
From: [MM/DD/YYYY] To: [MM/DD/YYYY] Certification: [FIELD OF STUDY]

PREVIOUS EMPLOYMENT

Employer 1: [EMPLOYER NAME] E-mail: [EMPLOYER EMAIL]
Phone: [EMPLOYER PHONE] Address: [EMPLOYER ADDRESS]
Start Pay: $[PAY AMOUNT] ☐ Hour ☐ Salary  End Pay: $[PAY AMOUNT] ☐ Hour ☐ Salary
Job Title: [PREVIOUS POSITION] Responsibilities: [PREVIOUS DUTIES]
From: [MM/DD/YYYY] To: [MM/DD/YYYY]  Reason For Leaving: [EXPLAIN TERMINATION]

Employer 2: [EMPLOYER NAME] E-mail: [EMPLOYER EMAIL]
Phone: [EMPLOYER PHONE] Address: [EMPLOYER ADDRESS]
Start Pay: $[PAY AMOUNT] ☐ Hour ☐ Salary  End Pay: $[PAY AMOUNT] ☐ Hour ☐ Salary
Job Title: [PREVIOUS POSITION] Responsibilities: [PREVIOUS DUTIES]
From: [MM/DD/YYYY] To: [MM/DD/YYYY]  Reason For Leaving: [EXPLAIN TERMINATION]

REFERENCES

Name: [REFERENCE NAME] Relationship: [REFERENCE RELATION]
Company: [REFERENCE EMPLOYER] Title: [REFERENCE TITLE]
E-mail: [REFERENCE EMAIL] Phone: [REFERENCE PHONE]

Name: [REFERENCE NAME] Relationship: [REFERENCE RELATION]
Company: [REFERENCE EMPLOYER] Title: [REFERENCE TITLE]
E-mail: [REFERENCE EMAIL] Phone: [REFERENCE PHONE]

MILITARY SERVICE

Are you a veteran? ☐ Yes ☐ No Branch: [MILITARY BRANCH]
From: [MM/DD/YYYY] To: [MM/DD/YYYY]
Discharge Rank: [MILITARY RANK] Discharge Type: [DISCHARGE TYPE]
If not honorable, please explain: [EXPLAIN DISHONORABLE DISCHARGE]

DISCLAIMER

If asked, are you willing to consent to a background check? ☐ Yes ☐ No

The applicant understands that this is an Equal Opportunity Employer who is committed to excellence through diversity. To ensure this application is acceptable, please complete the application fully in order for it to be considered. Please complete each section even if a resume is attached.

I, the applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.

Applicant Signature:                                                          Date:
Print Name: [APPLICANT NAME]

Sources

  1. CA CRD – Fair Chance Act
  2. § 1602.14
  3. §§ 12952(a), 432.3(b)
  4. §§ 8-2-130(3)(a)(iii), 8-5-102(2)(a)
  5. §§ 31-51i(b), 31-40z(b)(5)
  6. § 709B(b)(2)
  7. §§ 378-2.5(b), 378-2.4(a)(1)
  8. §§ 15(a), 10, 10(b-10)
  9. §§ 600-A(2)(A), 628-A(2)
  10. § 3-304.2(b)(1)(ii)(2.)
  11. § 105A(c)(2)
  12. § 364.021(a)
  13. §§ 34:6B-14(2), 34:6B-13, 34:6B-20(1)(a)
  14. §§ 296(16), 8-107(11-a)(3), 8-102, 194-a(b)
  15. § 659A.357
  16. § 28-6.14-1(a)
  17. § 495j(a)
  18. §§ 49.94.010(1), 49.58.100