You may present a solid copy of your resume to the staffing coordinator. Please fill out all the information below as completely as possible.
Your First Name: *
Your Last Name: *
Your Street Address: *
Your City: *
Your State: *
Your Zip Code: *
Your Primary Phone: *
Your Secondary Phone (optional):
Your Email: *
Your Social Security Number: *
Your information is kept private and secured. All digital traces of your information will be erased after form submission.
Job Information
Please fill out the information below as to what position you are seeking to fill.
Position Applying For: *
Desired Status: *
Days and Times You Are Available (Enter All): *
Have you ever worked for this company? *
If yes, when?
Other positions you feel qualified for (optional):
Desired Salary or Salary Range: *
Are you a citizen of the United States? *
If no, are you authorized to work in the United States?
Means of Transportation: *
Professional Licenses
Please enter any professional licenses that you have acquired as well as the registration number, date of expiration, and state in which the license is valid. DO NOT ENTER YOUR DRIVER'S LICENSE INFORMATION.
License #1 Type:
Registration #:
Expires:
State:
License #2 Type:
Registration #:
Expires:
State:
License #3 Type:
Registration #:
Expires:
State:
Education Information
Please enter all of your education information below.
High School Name: *
High School Street Address: *
High School City: *
High School State: *
High School Zip: *
What year did you start? *
What year did you end? *
Did you graduate? *
Degree: *
Name of college/university/technical school/secondary school attended (optional):
School Street Address:
School City:
School State:
School Zip Code:
Year Started:
Year Ended:
Did you graduate?
Degree/Certificate Awarded:
Name of college/university/technical school/secondary school attended (optional):
School Street Address:
School City:
School State:
School Zip:
Year Started:
Year Ended:
Did you graduate from this school?
Degree/Certificate Awarded:
Military Service
All information below is optional. If you do not have any information for this section please proceed to the next section "Employment History".
Branch of military service:
What year did you enlist?
What year did you finish?
Rank at discharge:
Type of discharge:
If other than honorable, explain:
Employment History
Please fill out your employment history below. Summarize all job responsibilities.
First Place of Employment: *
Company Name
Your Job Title: *
Company Street Address: *
Company City: *
Company State: *
Company Zip: *
Company Phone Number: *
Supervisor's Name: *
May we contact this supervisor? *
Starting Salary:
Ending Salary:
Job responsibilities: *
Reason for leaving: *
Second Place of Employment:
Company Name
Your Job Title:
Company Street Address:
Company City:
Company State:
Company Zip Code:
Company Phone Number:
Supervisor's Name:
May we contact this person?
Starting Salary:
Ending Salary:
Job Responsibilities:
Reason for leaving:
Third Place of Employment:
Your Job Title:
Company Street Address:
Company City:
Company State:
Company Zip Code:
Company Phone Number:
Supervisor's Name:
May we contact this person?
Starting Salary:
Ending Salary:
Job Responsibilities:
Reason for leaving:
References
Please enter three (3) professional reference below that can attest to your work habits, ethic, and skill. Please use at least one supervisor from a prior job.
Reference #1 First Name: *
Reference #1 Last Name: *
Reference #1 Company: *
Reference #1 Phone: *
Reference #1 Email: *
Reference #1 Relationship: *
Co-worker, supervisor, peer, etc.
Reference #2 First Name: *
Reference #2 Last Name: *
Reference #2 Company: *
Reference #2 Phone: *
Reference #2 Email: *
Reference #2 Relationship: *
Co-worker, supervisor, peer, etc.
Reference #3 First Name: *
Reference #3 Last Name: *
Reference #3 Company:
Reference #3 Phone: *
Reference #3 Email: *
Reference #3 Relationship: *
Co-worker, supervisor, peer, etc.
History
Past criminal convictions are not bar to employment but will be considered in relation to specific positions.
Have you ever been convicted of a felony, misdemeanor, or charged with a criminal offense? *
If yes, please provide an explanation of all pertinent information including charges, sentence, and date.
Disclaimer
I grant Greater Boston Staffing Company permission to conduct reference and Criminal Offender Record Information (CORI) checks, and I release Greater Boston Staffing Company and its affiliates from all liability resulting from this inquiry and releasing my personal information to the officials whenever requested. I hereby certify that the answers and other information on this application are true and correct and that I understand that my employment does not create a contract of employment for any particular time. I understand that Greater Boston Staffing Company reserves the right to discharge employees with or without cause or notice. I understand, also, that I am required to abide by all rules and regulations of Greater Boston Staffing Company and its affiliates where necessary. Failure to comply with these policies and guidelines may result in termination of employment. Your application will be reviewed. We will contact you if we have an opening which appropriately matches your skills and experience. In the event that there are no openings at the present time we will keep your application on active file for 45 days.
Digital Signature: Please type first and last name. *
This digital signature verifies that all the information presented above is true and and correct to the best of your knowledge.
To verify that you have read this disclaimer please enter the last four digits of your phone number: *
Last four of phone
Today's Date: *
mm/dd/yyyy
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