PERSONAL INFORMATION:                                               
__________________________________________________

Last Name
First Name
Mailing Address
City
State
Zip Code
Phone(where you can be reached)
Business Phone
Contact Email

Position you are interested in? 
Location you are interested in working? 
Did anyone recommend Holt Supply to you?

Do you have a relative or friend already  working for us?
If so, please list who/where:


What is your availability?
Regular Full Time
Regular Part Time
Temporary Full Time
Temporary Part Time
Shift or Split Shift Work
Date available to work?

Have you placed an application with usin the last 2 years?


EDUCATION:                                                                          
__________________________________________________

Check the highest grade you have completed:
Highschool:  9 10 11 12
GED:

College Experience:
2 Year College You Attended: 
Did You Graduate?
Degree:

4 Year College You Attended: 
Did You Graduate?
Degree:

Please list other College Experience if applicable:



  KNOWLEDGE AND SKILLS:                                               
__________________________________________________

Please list all computer programs and skills:



BACKGROUND:                                                                  
__________________________________________________

Have you ever been convicted of a misdemeanor or felony?
If so, please explain:

Do you have Military Experience?
Branch
Date Entered
Date Discharged

Service schools special expertise

Do you have a valid Driver's License?

Do you have any driving offenses in the last 2 years?
If so, please explain:



EMPLOYMENT HISTORY:                                                 
__________________________________________________

Current/Past Employer
Mailing Address
City
State
Zip Code
Name of Supervisor
Supervisor Contact Number
Date Employed (mo/day/year)
Date Separated (mo/day/year)
May we contact your employer?
Please list your duties in this position:

__________________________________

Current/Past Employer
Mailing Address
City
State
Zip Code
Name of Supervisor
Supervisor Contact Number
Date Employed (mo/day/year)
Date Separated (mo/day/year)
May we contact your employer?

Please list your duties in this position:

__________________________________

Current/Past Employer
Mailing Address
City 
State  
Zip Code
Name of Supervisor 
Supervisor Contact Number
Date Employed (mo/day/year)
Date Separated (mo/day/year)
May we contact your employer?Yes  No
Please list your duties in this position:


__________________________________



Thank you for taking the time to submit your information.

You may also email a copy of your full resume to:
resumes@holtsupply.com

Mail to the following:
Holt Supply Resumes
P.O. Box 1365
Bloomington, IL 61702-1365
 
Or submit your resume via fax at 309.820.9744