HTML code for "Employment Application" web form

The "Employment Application" form is an important form for any business!

Click here to see how your form will look like

This form is completely customizable!
JavaScript validates required fields; plus there is a verification on the server-side.
Captcha image protects the form against SPAM.
Captcha image can be reloaded.
There are many styles of Captcha image available.


This is ProCaptcha code. Free BasicCaptcha code is here.

How to use ProCaptcha code

1. Create an account if you have not done it yet.

2. Copy and paste the code below into your webpage.

3. Specify a form in your profile with SnapHostID 3B2WXWKEMZAA.


<h2>Employment Application</h2>
<script type="text/javascript">
function ValidateForm(frm) {
if (frm.First_Name.value == "") {alert('First name is required.');frm.First_Name.focus();return false;}
if (frm.Last_Name.value == "") {alert('Last name is required.');frm.Last_Name.focus();return false;}
if (frm.Email_Address.value == "") {alert('Email address is required.');frm.Email_Address.focus();return false;}
if (frm.Email_Address.value.indexOf("@") < 1 || frm.Email_Address.value.indexOf(".") < 1) {alert('Please enter a valid email address.');frm.Email_Address.focus();return false;}
if (frm.Position.value == "") {alert('Position is required.');frm.Position.focus();return false;}
if (frm.Phone.value == "") {alert('Phone is required.');frm.Phone.focus();return false;}
if (frm.CaptchaCode.value == "") {alert('Enter security code.');frm.CaptchaCode.focus();return false;}
return true; }
function ReloadCaptchaImage(captchaImageId) {
var obj = document.getElementById(captchaImageId);
var src = obj.src;
var date = new Date();
var pos = src.indexOf('&rad=');
if (pos >= 0) { src = src.substr(0, pos); }
obj.src = src + '&rad=' + date.getTime();
return false; }
</script>
<hr />
<form id="ExampleForm" action="http://www.SnapHost.com/captcha/WebFormSubmit.aspx"
onsubmit="return ValidateForm(this);" method="post">
<input id="SnapHostID" name="SnapHostID" type="hidden" value="3B2WXWKEMZAA" />
<table border="0" cellpadding="5" cellspacing="0">
<tr>
<td style="width:50%">
<b>First name *</b><br />
<input name="First_Name" type="text" maxlength="50" style="width:260px" />
</td>
<td style="width:50%">
<b>Last name *</b><br />
<input name="Last_Name" type="text" maxlength="50" style="width:260px" />
</td>
</tr>
<tr>
<td colspan="2">
<b>Email *</b><br />
<input name="Email_Address" type="text" maxlength="100" style="width:535px" />
</td>
</tr>
<tr>
<td colspan="2">
<b>Portfolio website</b><br />
<input name="Portfolio" type="text" maxlength="255" value="http://" style="width:535px" />
</td>
</tr>
<tr>
<td colspan="2">
<b>Position you are applying for *</b><br />
<input name="Position" type="text" maxlength="100" style="width:535px" />
</td>
</tr>
<tr>
<td style="width:50%">
<b>Salary requirements</b><br />
<input name="Salary" type="text" maxlength="50" style="width:260px" />
</td>
<td style="width:50%">
<b>When can you start?</b><br />
<input name="StartDate" type="text" maxlength="50" style="width:260px" />
</td>
</tr>
<tr>
<td style="width:50%">
<b>Phone *</b><br />
<input name="Phone" type="text" maxlength="50" style="width:260px" />
</td>
<td style="width:50%">
<b>Fax</b><br />
<input name="Fax" type="text" maxlength="50" style="width:260px" />
</td>
</tr>
<tr>
<td colspan="2">
<b>Are you willing to relocate?</b><br />
<input name="Relocate" type="radio" value="Yes" checked="checked" /> Yes &nbsp; &nbsp; &nbsp;
<input name="Relocate" type="radio" value="No" /> No &nbsp; &nbsp; &nbsp;
<input name="Relocate" type="radio" value="NotSure" /> Not sure
</td>
</tr>
<tr>
<td colspan="2">
<b>Last company you worked for</b><br />
<input name="Organization" type="text" maxlength="100" style="width:535px" />
</td>
</tr>
<tr>
<td colspan="2">
<b>Reference / Comments / Questions</b><br />
<textarea name="Reference" rows="7" cols="40" style="width:535px"></textarea>
</td>
</tr>
</table>
<br />
<div style="text-align:center;">
<table border="0" cellpadding="0" cellspacing="0" style="text-align:center; width:300px; margin:auto;">
<tr>
<td><i>Enter security code</i></td>
<td>SECURITY CODE</td>
</tr>
<tr>
<td>
<input name="CaptchaCode" type="text" maxlength="6"
style="width:130px; height:28px; font-size:24px; text-align:center;" />
</td>
<td>
<a href="http://www.SnapHost.com"><img id="CaptchaImage"
style="border:1px solid #999999; vertical-align:bottom;" alt="Web Form Security Code" title="Anti-spam web forms"
src="http://www.SnapHost.com/captcha/WebForm.aspx?id=3B2WXWKEMZAA&ImgType=2" /></a>
<br /><a href="#" onclick="return ReloadCaptchaImage('CaptchaImage');"><span style="font-size:12px;">reload image</span></a>
</td>
</tr>
</table>
<br /><br />
<input name="Submit" type="submit" value="Send Application" />
</div>
</form>