APPLICATION - Pegasus Northwest

online application

Thank you for your interest in Pegasus Northwest. Please fill out the following application and we will contact you shortly.

Required *

Name*		A value is required.
Social Security Number		A value is required.
Address
City
State
Zip
Phone*		A value is required.
E-Mail*		A value is required.
Position Applied for:
Are you 18 or older?
If hired, when can you start?

Education:
High School		Years
College		Years
Other/Technical		Years

Previous Employer:
Employer
Fiel of work
Wage		Starting Wage Ending Wage
Date		Date Started Date Ended
Reason for Leaving?
May We Contact?		Yes No
Supervisor
Phone Number

Previous Employer:
Employer
Fiel of work
Wage		Starting Wage Ending Wage
Date		Date Started Date Ended
Reason for Leaving?
May We Contact?		Yes No
Supervisor
Phone Number

Previous Employer:
Employer
Fiel of work
Wage		Starting Wage Ending Wage
Date		Date Started Date Ended
Reason for Leaving?
May We Contact?		Yes No
Supervisor
Phone Number

References (Do not include relatives) This list should contain atleast 1 previous supervisor.

Name
Phone Number
Name
Phone Number
Name
Phone Number

Are you currently employed?		Yes No
Type of work desired
Salary desired
How were you referred?

Do you have any relatives who are employed at Pegasus NW?		Yes No (If yes, please give names)


Is there any information we would need about your name for us to check your work record?		Yes No (If yes, please explain)


Have you ever been convicted of a crime?		Yes No (If yes, please explain)


Are there any felony charges pending against you?		Yes No (If yes, please explain)


Please list any additional training, licenses or hobbies that may be related to the job.


If you have a Resume, please attach it here.
SECURITY QUESTION: (Please note, if you get the captcha wrong, all info will be lost. Refresh captcha untill you can read the letters.)