Employment Application

Personal Information

⚠️ SSN Note: Voluntary for W-2.

⚠️ ID Note: Driver's license recommended.

Date *

Last Name *

First Name *

Middle Initial

SSN * (Enter 9 digits, dashes optional)

Street Address *

City *

State *

ZIP *

Phone *

Email *

Front of ID *

Back of ID *

US Citizen? *

Yes No

Work Auth? *

Yes No

Worked for us before? *

Yes No

Details *

Felony? *

Yes No

Explain *

Position, Availability & Education

Position *

Start Date *

Type *

Desired Salary

How Heard

Education

High School

Graduated?

Yes No

College

Graduated?

Yes No

Trade School

Graduated?

Yes No

Additional Edu Info

Work Experience, References & Military

Work #1 *

May Contact?

Yes No

Responsibilities *

Work #2 *

May Contact?

Yes No

Responsibilities *

Work #3 *

May Contact?

Yes No

Responsibilities *

Professional References

Ref #1 *

Ref #2 *

Ref #3 *

Military Service

Additional Info, W‑2 & Signature

Skills

Languages

Activities

Comments

W‑2 & Payroll

📌 IRS Note: Employers must collect correct name and SSN for W-2.

Legal Name (SSN)

SSN (W-2)

Filing Status

Allowances

W‑2 File *

Disclaimer & Signature

I certify the information is true. I authorize CBO Group to verify my background.

I authorize background checks *

Signature *

Date *