Full Name Position Desired
Address City State Zip Code
Email Address Primary Phone Secondary Phone
Days/Hours you are available to work
Mon From:  To:  Can you work nights?   
Tues From:  To:  Status Desired    
Wed From:  To:  How soon can you start?  
Thurs From:  To:  Are you eligible to work in the U.S.?     
Fri From:  To: 
Sat From:  To: 
Sun From:  To: 
Have you ever been employed by Olu's Home Inc.?
If yes, please provide dates of employment & reason for leaving: 
Are you related to any Olu's Home Inc. Employees?
If yes, please provide their name & relationship to you: 
Do you have a valid Drivers License?
If yes, please provide state of issuance, license#, and exp date: 
Do you have an acceptable Motor Vehicle Record (no more than 2 violations in 3 years; no more than 3 vehicle related suspensions or reinstatements, no reckless or felony driving convictions)?
If yes, please explain: