Employee Application
Last 4 numbers of your SSN:
Salutation:
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*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:
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* 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 
All Locations
Aloha
Any East
Any West
Aurora
Beaverton
Bend
Camas
Clackamas
Culver
Fairview
Gresham
Hazel Dell
Hillsboro
Hubbard
Kelso
Lake Oswego
Longview
Madras
Milwaukie
Minnehaha
Orchards
Oregon City
Portland
Portland - N
Portland - NE
Portland - NW
Portland - SE
Portland - SW
Prineville
Redmond
Ridgefield
Salmon Creek
Sherwood
Sisters
Sun River
Tigard
Tualatin
Vancouver
Wilsonville
Woodburn
Woodland

Skill Title 
Yes 
[Collapse]Skill Set: 0010 DRIVER
 License
 CDL-A
 CDL-B
 CDL-C
 Tractor Trailer
 Delivery Truck
 Delivery Van
 Automatic
 Clutch
[Collapse]Skill Set: 0010 EQUIPMENT
 Backhoe
 Bulldozer
 Outside Forklift
 Crane
 Drill
 Saw
 Nail Gun
 Jack Hammer
[Collapse]Skill Set: 0010 MAINTENANCE
 Building Repair
 Machinery Repair
 FloorCare
 Landscape
 Lawncare
 Hotel Cleaning
 Janitorial
[Collapse]Skill Set: 0010 SKILLED
 Welder
 Machinist
 Demolition
 Supervisor
 Carpenter
 Construction
 Plumber
 HVAC
 Electrician
 Mechanic
 Painter
 Flagger
 Mover
 Laundry
 Road Crew
 Digger/Raker
 General Labor
 Milwright
 Concrete
[Collapse]Skill Set: 0010 SUPPLIES AVAILABLE
 Hard Hat
 Tools
 Safety Glasses
 Steel Toe Work Boots
 Fluorescent Vest
 Gloves
[Collapse]Skill Set: 0010 WAREHOUSE
 Computer Skills
 Receiving
 Shipping
 Load/Unload
 Hand Jack
 Forklift
 Stand Up
 Sit Down
 Cherry Picker
 Inventory
 Order Selector
[Collapse]Skill Set: 0999 FACTORY
 Mechanical Assembler
 Electronic Assembler
 Solderer
 Inspector
 Picker/Packer
 Quality Control
 Machine Operator
 Production Line
 Production Cell
 PC Board Assembler

Enter as much information as you can. More details will help us better serve you.
(Salary/Pay per hour: NOT REQUIRED in AL, CA, CO, CT, DE, HI, IL, MA, ME, NJ, NY, OR, VT, WA)

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 information on this application is true and factual
  


Submit Your Application


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