Skilled Staffing Job Application
Applicant's Information
Date of Application *
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First Name *
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Middle *
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Last Name *
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Present Address *
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Apt. #
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City *
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State *
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Zip Code *
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Telephone *
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Position Applying For
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Preference ex. full time, part time, seasonal
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Are you willing to work overtime as necessary?
Date Available
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Only U.S. Citizens or aliens who have a legal right to work in the U.S. are eligible for employment. Can you, upon employment, submit documentation verifying your legal right to work in the U.S. and your identity? *
Have you ever pled guilty or “no contest” to, or been convicted of, a misdemeanor of felony?. If yes please explain *
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Are you 18 years of age or older? *
Have you ever been employed by Skilled Staffing? If Yes, state dates of employment, location and position title: *
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Have you ever been terminated or asked to resign from any job? If Yes, please explain circumstances and provide dates: *
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Please explain any gaps in your employment history:
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May we contact your employer? If No, please explain:
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How did you hear about this position? (Please specify the name of the source, agency, etc.)
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Skill/Qualification:
License/Certificate Number:
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State & Exp Date:
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Educational History
Name of the School
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#Years Attended
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Field of Study
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Degree
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Personal References
Provide us with (2) Personal References (Family or Friends)
(1)Name: *
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Ref. Phone Number: *
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(2)Name: *
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Ref. Phone Number:: *
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Employment Record
Provide us with (2) Professional References
First Reference
Company Name: *
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Supervisor’s Name: *
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Pay Rate:
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Employer Full Address:
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Tel: *
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From:
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To:
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Position:
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Work Performed:
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Reason for Leaving:
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Second Reference
Company Name:: *
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Supervisor’s Name:: *
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Pay Rate::
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Employer Full Address::
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Tel:: *
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From::
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To::
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Position::
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Work Performed::
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Reason for Leaving::
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Can you read Blueprints?
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List your Skills
List your Skills
Please Select any TOOLS that you currently OWN
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