Application for Employment
Position Applying For:
  
First Name:  
Middle:  
Last Name:  
Address  
City:  
State:  
Zip Code:  
Email:  
   
Phone 1:    
Phone 2:    
Phone 3:    
If previously employed by Deluxe, show dates of employment.
From: To: Department:
Are you related to anyone presently employed by Deluxe?
No Yes - If Yes, who?:
Have you ever been convicted of a felony?
No Yes - If Yes, please explain:
Are you a US citizen?
No Yes
     If No, Visa Class:
Are you available to work shift work if the position you are applying for requires it?
No Yes
Are you a veteran of the United States Military Service?
No Yes - Branch: Dates:
Education
High School Graduate or Equivalent?
No Yes
Last Attended: High School College Other:
Course of Study?
  
Dates Attended:  
Name of School:  
Location:  
Degree (BS, BA, MA, etc):  
Employment History
1
Company Name:  
Address:  
Telephone Number:  
Job Title:  
Full Time Part Time
Duties:  
Supervisor:  
From: To:
Starting Wage: $
Ending Wage: $
Reason for leaving:  
2
Company Name:  
Address:  
Telephone Number:  
Job Title:  
Full Time Part Time
Duties:  
Supervisor:  
From: To:
Starting Wage: $
Ending Wage: $
Reason for leaving:  
3
Company Name:  
Address:  
Telephone Number:  
Job Title:  
Full Time Part Time
Duties:  
Supervisor:  
From: To:
Starting Wage: $
Ending Wage: $
Reason for leaving:  
4
Company Name:  
Address:  
Telephone Number:  
Job Title:  
Full Time Part Time
Duties:  
Supervisor:  
From: To:
Starting Wage: $
Ending Wage: $
Reason for leaving:  
References
Name:  
Address:  
Phone Number:  
Occupation:  
Years Known:  
Name:  
Address:  
Phone Number:  
Occupation:  
Years Known:  
Name:  
Address:  
Phone Number:  
Occupation:  
Years Known:  
Other Information
Other skills or qualifications you would like us to consider:  
How/where did you learn about this vacancy?  
Finally
Deluxe is an Equal Employment Opportunity Employer. We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disablity, marital status, veteran status, sexual orientation, or any other legally protected status.

If you have any problems filling out this form you can call 1-505-892-8090 to ask for assistance or arrange an alternative method for applying. You can also download a printable version of this form: Download printable application form in Adobe Acrobat PDF format

As a condition of employment, applicants will be required to provide a valid Social Security Number and/or proof of citizenship or immigration status.

Do not send SS# or sensitive information via this unsecure form.

By submitting this form, you certify that information provided is
true and complete to the best of your knowledge.