Staffing Application Form

Equal Employment Opportunity. It is our policy to seek and employ the best qualified personnel in all of our facilities and to provide equal opportunity for the advancement of employees and to administer all of our personnel policies in a manner that will not discriminate against any person because of race, color, religion, age, sex, marital or veteran status, national origin, ancestry, disability (physical or mental handicap) or any other legally protected status. Click Here for Secure Page

Last Name: First Name: Middle Initial:
Social Security Number: Date of Birth:
Email Address:
Address: Apt Number:
City: State: Zip:
Phone Number: Alt Phone Number:

Educational Background

Name of High School:
Name and Location of College:
Years Attended: Degree: Major/Subject Studied:
Name and Location of Trade School:
Years Attended: Degree: Major/Subject Studied:

Employment History

Employer Name: Employer Address: Date (to - from): Ending Salary:
Position: Contact:
Reason for Leaving:

Employer Name: Employer Address: Date (to - from): Ending Salary:
Position: Contact:
Reason for Leaving:

Employer Name: Employer Address: Date (to - from): Ending Salary:
Position: Contact:
Reason for Leaving:

Employer Name: Employer Address: Date (to - from): Ending Salary:
Position: Contact:
Reason for Leaving:

Employer Name: Employer Address: Date (to - from): Ending Salary:
Position: Contact:
Reason for Leaving:

References

Give the names of three persons not related to you, whom you have known at least one year.

Name: Address:
Phone: Business: Years Known:

Name: Address:
Phone: Business: Years Known:

Name: Address:
Phone: Business: Years Known:

Work Experience and Trade Skills

If you have one or more years Professional Experience in any of the following trades, please indicate the number of years experience for each trade.

Clerical       Data Entry       Apartment Housekeeping
Accountant       Estimated WPM       Apartment Leasing
Billing       Medical       Apartment Maint. EPA Cert
Bookkeeping       Sales       Apartment Maint. General
10-Key by Sight       Foreign Language       Apartment Make Ready
10-Key by Touch       Teacher       Apartment Management
Computer Skills: Word       Substitute       Apartment Porter/Pools
Computer Skills: Excel       Tutor       Landscape Maintance
Front Desk / Reservations       Baker       Carpentry
Night Audit       Single Cook/Night Cook       Plumbing
Laundry       Hot/Cold Food Prep.       Roofing
Housekeeping       Banquet Server/Busser       Masonry (Brick/Tile/Elect)
Host/Hostess       Restaurant Server       Cement Work
Coat Check       Restaurant Bartender       Drywall
Cocktail Server       Night Club Bar Bartender       Electrical Wiring
Banquet Set-up/Valet Runner       Mechanized Dishwashing       Heavy Equipment Operation
Other       Other       Carpet Installation
Do you have training in fair housing compliance regulations? (Y/N)
Do you have current TABC certificate? (Y/N)  Do you have food handlers permit? (Y/N)
Restaurant Management? (Y/N)  Offsite Banquet Captain? (Y/N)
Hotel Banquet Captain? (Y/N)
Additional Trade skills, Certifications, tools, ect. Which might be useful in determining job assignments for you.
Have you ever been:
Convicted of any felony
Convicted of any crime involving theft
Convicted of any crime involving credit card fraud / abuse
Discharged from any employment for theft /dishonest / fraud

A conviction record will not necessarily be a bar to employment, and factors such as age and time of the offense, seriousness and nature of the violation and rehabilitation will be taken into account.

Explain any Yes Answer:

Have you ever worked for a temporary employment service before?
If Yes please list Name of Business and Type of Work in the box below:

Security test. Please identify the pictures:




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