MY FACT SHEET Complete and carry with you on your job search

Applicant’s Name (Last) First Middle Initial									Social Security Number - -
Mailing Address (Number) Street									Work Telephone Number ( )
City State Zip Code									Home Telephone Number ( )
EDUCATION
Name of School	Location of School						Degree or Course of Study			Date Completed
EMPLOYMENT HISTORY – Begin with your most recent job. List each job separately.
Job Title		Dates Worked From ______ To _______							Pay $ ______ Per _____
Name of Employer						Name of Supervisor
Address: City State Zip Code
Telephone Number ( )				Reason for Leaving:
Duties Performed:
Job Title		Dates Worked From ______ To _______							Pay $ ______ Per _____
Name of Employer						Name of Supervisor
Address: City State Zip Code
Telephone Number ( )				Reason for Leaving:
Duties Performed:
Job Title		Dates Worked From ______ To _______							Pay $ ______ Per _____
Name of Employer						Name of Supervisor
Address: City State Zip Code
Telephone Number ( )				Reason for Leaving:
Duties Performed:
Job Title		Dates Worked From ______ To _______							Pay $ ______ Per _____
Name of Employer					Name of Supervisor
Address: City State Zip Code
Telephone Number ( )				Reason for Leaving:
Duties Performed:
PERSONAL REFERENCES: List the names of three references that employers may contact.
1) Name			Telephone # ( )					Relationship (Teacher etc.)
Address: City State Zip Code
2) Name			Telephone # ( )					Relationship (Teacher etc.)
Address: City State Zip Code
3) Name			Telephone # ( )					Relationship (Teacher etc.)
Address: City State Zip Code