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Job Application

Fayette Resources Job Application. Please fill this out as much as possible. Thank you.

Please Enter Your Name *

First

Middle

Last

Your Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Best Phone Number to Reach You: *

Are You Over 18 Years of Age? *

Yes
No

Type of Work & Position Desired

Have you lived in Pennsylvania for the past two (2) consecutive years?

Yes
No

Date Available for Work *

Type of Work Desired ? *

Days&Hours Interested in working :

Have you worked for Fayette Resources before ? *

If Yes, please indicate when and which location :

Please state the reason for leaving :

Have you ever been convicted of a felony or misdemeanor ?

Yes
No

Have you ever been charged or convicted of federal benefit program abuse or fraud ?

Yes
No

Education Background

High School Name

Location, City & State

Did You Graduate?

Yes
No

Year Graduated

Diploma, Certificate or Degree Received?

Vocational School ( if applies )

Location, City & State

Did you Graduate?

Yes
No

Year Graduated

Diploma, Certificate or Degree Received?

College (If applies)

Location, City & State

Year Graduated

Did you Graduate?

Yes
No

Diploma, Certificate or Degree Received?

Are you attending school currently?

Yes
No

If Yes, School Name:

Subjects

Scholastic Honors/College or High School Activities:

Professional Certifications - Specify states or registration & license numbers:

Reference #1

Please Enter Your Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How Many Years Known?

Phone

Email

Reference #2

Please Enter Your Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How Many Years Known?

Phone

Email

Reference #3

Please Enter Your Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

How Many Years Known?

Phone

Email

Military Background

Have you served in the Armed Forces?

Yes
No

Military Branch Type:

Date Entered:

Date Discharged:

Rank at Discharge?

Special training received in the Military?

Work History

Company Name

Phone

Start Date

End Date

Starting Wage:

Ending Wage:

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Supervisor's Name

May we contact this employer?

Yes
No

Your Position

Responsibilities/Duties:

Specific reason of leaving:

Uniontown Office

1 Millennium Drive, Suite 2
Uniontown, PA 15401

Phone: (724) 437-6461

Fax: (724) 437-5451

A world of opportunities.

Dubois Office

1100 Sykesville School Road
Reynoldsville, PA 15851

Phone: (814) 372-2115

Fax: (814) 372-2119

Indiana Office

2450 Philadelphia Street
Suite 900
Indiana, PA 15701

Phone: (724) 464-5270

Fax: (724) 464-4272

Pittsburgh Office

1112B Fells Church Road
Rostraver Twp, PA 15012

Phone: (412) 382-7191

Fax: (412) 382-7194

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