E

Personal Data
Last Name:
(Please print clearly or type)

Employment Application
Ericsson is an Equal Opportunity Employer / Affirmative Action Employer
Date:

First Name:

Initial:

Have you ever used another name? If yes, please provide other name(s): Current Address Street (No P.O. Box): Previous Address - Street (No P.O. Box): Has Ericsson or one of its affiliated or subsidiary companies ever employed you? Yes No What position are you applying for? Position Title: Location: City: City:

If you have a confidential email address, please provide it below: State: State: Zip Zip Telephone w/ area code: () Telephone w/ area code: () How long? From: To: How long? From: To:

If yes, indicate location & date(s): Location: From: To: Desired Pay?

Previous Employee #: Availability?

Education (You may be asked to provide transcripts and a waiver allowing access to educational records.)
Name, City and State Degree Major
Did you graduate?

Graduation Dates
(MM/YYYY)

High School

(List professional references only) Title

Yes

No

College(s)

Yes

No

Graduate School(s) Other(s)

Yes

No

Yes

No

References

Name

Company

Work Phone

Patents, Inventions, and/or Publications

___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________

EUS/H/ER-01:009 G:/Staffing/Appendix A/External Application.doc

Rev A

06/20/00

Confidential Document

Employment History
Employer:

Employment Information
Address (city & state): Area Code/Telephone:

List full-time, part-time, or voluntary work including military service for the last 10 years, starting with the most recent position. Complete entirely do not write, See Resume. If necessary, please use additional paper. (Please print clearly or type)

If Contract / Temp. position, please list agency & address: Date Started: Date Ended: Name and title of supervisor: Starting Salary: Starting Position:

Ending Salary:

Ending Position: Reason for Leaving:

Briefly describe your responsibilities: Employer: If Contract / Temp. position, please list agency & address: Date Started: Date Ended: Starting Salary: Starting Position: Address (city & state): Area Code/Telephone:

Ending Salary:

Ending Position:

Name and title of supervisor:

Reason for Leaving:

Briefly describe your responsibilities: Employer: If Contract / Temp. position, please list agency & address: Date Started: Date Ended: Starting Salary: Starting Position: Address (city & state): Area Code/Telephone:

Ending Salary:

Ending Position:

Name and title of supervisor:

Reason for Leaving:

Briefly describe your responsibilities:

Please explain any gaps in your employment history of more than 90 days:

May we contact your present employer while you are currently employed?

yes

no

Need for Work Authorization

(Please answer the following question(s) only as instructed below.) 1. Are you a U.S. citizen, a lawfully admitted Permanent Resident, a lawfully admitted Temporary Resident (does not include non-immigrants holding short-term visas issued by U.S. consulates abroad, such as B, F or H1-B visas), an Asylee or Refugee?

Yes If yes, do NOT answer Question 2.

2. Please indicate your current nonimmigrant status:

No - If no, please answer Question 2. An answer of no will not automatically exclude you from further consideration for employment. Date nonimmigrant status expires:

EUS/H/ER-01:009 G:/Staffing/Appendix A/External Application.doc

Rev A

6/02/00

Confidential Document