Preliminary Application for Employment
Valiant Products Corporation 2727 W 5^th Avenue Denver, CO 80204 303-892-1234

Applicant Information
Last Name	First Name			M.I. Date
Street Address				Apartment/Unit #
City	State			ZIP
Phone	E-mail Address
Position Applied for
Are you available to work Full-Time, Monday-Friday, 8:00-5:00?		YES NO
What date are you available to begin employment?
Have you ever been convicted of a felony? YES NO		If yes, explain
Education
Name of High School	City, State
Did you graduate? YES NO
Name of College	City, State
Did you graduate? YES NO	Degree
Other Education	City, State
Did you graduate? YES NO	Degree
Previous Employment
Company			City, State
Job Title		Starting Salary $				Ending Salary $
Dates  To	Reason for Leaving
Company			City, State
Job Title		Starting Salary $			Ending Salary $
Dates  To	Reason for Leaving
Company			City, State
Job Title		Starting Salary $			Ending Salary $
Dates  To	Reason for Leaving

AN EQUAL OPPORTUNITY EMPLOYER

We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.

This is a preliminary application. A more complete application may be required during the evaluation and interview process.