Employee Application
Last 4 numbers of your SSN:
Salutation:
v
*First Name:
Middle Initial:
*Last Name:
Nickname:
Address:
* City:
* State:
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* Zip:
*Home Phone:
Enter only numbers, area code first:
Cell Phone:
Enter only numbers, area code first:
Other Phone:
Enter only numbers, area code first:
Email:
In case of emergency, notify name:
Emergency Phone:
Enter only numbers, area code first:
Check if you are legally authorized to work in the United States:
* How did you hear of us:
v
 
* What position are you applying for:
Date available for work:
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Minimum rate per hour:
Days you are available to work full-time:
 
What shifts you are available to work:
Preferred Shift:
What times are you available to work from:
   
To:
   
Checking the below boxes indicates YES:  
Do you have transportation:
Will you accept a same day assignment:
Will you accept a long term assignment:
Are you available part-time:
Are you available full-time:
Are you available temp-hire:
Are you available direct-hire:
 
City 
Yes 
Algonia
Auburn
Burien
Federal Way
Fife
Kent
Lakewood
Puyallup
Renton
Seatac
Seattle
Spanaway
Sumner
Tacoma
Tukwila

Skill Title 
Yes 
[Collapse]Skill Set: 0001 WAREHOUSE
 Shipping
 Receiving
 Load/Unload
 Hand Jack
 Electric Pallet Jack
 Forklift - Stand Up
 Forklift - Sit Down
 Fklift - Cherry Pick
 Inventory
 Order Pick/Pack
[Collapse]Skill Set: 0011 FACTORY
 Mech. Assembler
 Elec. Assembler
 PC Board Assembler
 Solderer
 Inspector
 Picker/Packer
 Quality Control
 Machine Operator
 Production Line
 Production Cell
[Collapse]Skill Set: 0021 MAINTENANCE
 Building Repair
 Machinery Repair
 Floor Care
 Landscape
 Lawncare
 Hotel Cleaning
 Janitorial
[Collapse]Skill Set: 0031 SKILLED TRADE
 MIG Welder
 TIG Welder
 Welder
 Machinist
 CNC Machinist
 Mechanic
 CDL - A
 CDL - B
 CDL - C
 Delivery Truck
[Collapse]Skill Set: 0041 CLERICAL/CUSTOMER SERVICE
 Customer Service
 Telemarketing
 Filing
 Receptionist
 Administrative Asst
 Accounts Pay/Rec
 Data Entry Alpha/Num
 MS- Word
 MS - Excel
 MS - Powerpoint
[Collapse]Skill Set: 0051 IT
 Program/App Develop
 Project Management
 Help Desk / Tech Sup
 Networking
 Security
 Data Center
 Web 2.0
 Telecommunications
 Business Intelligenc
 Collaboration Archit

Enter as much information as you can. More details will help us better serve you.

Previous Employment #1

Dates of employment: From: To:
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v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:

Previous Employment #2

Dates of employment: From: To:
v
v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:
   

Previous Employment #3

Dates of employment: From: To:
v
v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:

Previous Employment #4

Dates of employment: From: To:
v
v
Name of employer:
Address:
City, State, Zip:
v
Phone:
Supervisor:
Job Position:
Pay per hour:
Reason for leaving:
 

Temporary Employment

FIRM # 1

FIRM # 2

Firm name:
Address:
City, State, Zip:
v
Please list at which clients you were placed, job category, and to whom you reported. Please share your thoughts on the agency and your assignment:
Firm name:
Address:
City, State, Zip:
v
Please list at which clients you were placed, job category, and to whom you reported. Please share your thoughts on the agency and your assignment:
 

High School Education

Name of high school:
High school degree:
High school diploma/certificate:

Business or Other Education

Name of school/program:
School/program degree:
School/program diploma/certificate:

College Education

Name of college:
College degree:
College diploma/certificate:
               
      “I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal and or reason not to hire. I authorize investigations of all statements contained herein and the references and employers listed in the application to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also authorize any reasonable, job related, pre-employment testing and background and reference verification. If employed, I further agree that New Era HR Solutions is my employer and as my employer can terminate employment with or without cause with or without notice. I also agree that if for any reason I am advanced money, loaned property, or receive pay that I have not earned, New Era HR Solutions is authorized to deduct from my wages sufficient funds to repay such advances, over payment, or to replace property. This waiver does not permit release or use of disability related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I also acknowledge that New Era HR Solutions will only keep application information for a period of one year.”
  


Submit Your Application


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