Affiliated Equipment Company, Inc.

15310 MacArthur Dr, North Little Rock, AR 72118
PO Box 13139, Maumelle, AR 72113
PH: 501-803-4111

Employment Application

Applications are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or handicap.

Personal Information Name Date Address D/O/B

Citizenship & Previous Application

U.S. citizen Not a U.S. citizen

Applied here before Never applied here

If Yes, When

Date you can start work

Employment Type & Availability

Full time Part time Temporary Available to Work Overtime

Legal

Ever convicted of a crime Never convicted

If Yes, explain

Employment Experience

Please provide at least one previous employer.

Employer 1 Employer Name

City

State

Zip

Phone No.

Supervisor's Name

Job Title

Reason for leaving

From

To

Salary/Hourly Rate

Employer 2 Employer Name

City

State

Zip

Phone No.

Supervisor's Name

Job Title

Reason for leaving

From

To

Salary/Hourly Rate