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 
Brea
Chino
Chino Hills
Corona
Fontana
Lake Elsinore
Los Angeles County
Mira Loma
Moreno Valley
Norco
North Orange County
Ontario
Perris
Pomona
Rancho Cucamonga
Rialto
Riverside
San Bernardino/Colton
South Orange County
Temecula
Upland/Montclair

Skill Title 
Yes 
[Collapse]Skill Set: 0001 WHSE/DIST/LOGISTICS
 Receiving
 Shipping
 Load/Unload
 Pallet Jack
 Stand up Forklift
 Sit down Forklift
 Cherry Picker
 Clamp
 Order Selector
 Inventory
[Collapse]Skill Set: 0011 MFG/PRODUCTION
 Mechanical Assembler
 Electrical Assembler
 Solderer
 Inspector
 Picker/Packer
 Quality Control
 Machine Operator
 Production Line
 Production Cell
 PC Board Assembler
[Collapse]Skill Set: 0021 MAINTENANCE
 Building Repair
 Machinery Repair
 Electrical
 Mechanical
 Janitorial
[Collapse]Skill Set: 0031 SKILLED
 Welder
 Machinist
 CNC
 Mill
 Lathe
 Grinder
[Collapse]Skill Set: 0041 INDUSTRY
 Cold Storage
 Clothing
 Plastics
 Metals
 Paper
 Wood
 Automotive
 Food
 Other
[Collapse]Skill Set: 0051 MANAGEMENT
 Operations
 Supervisor
 Manager
 Director
 Associates Degree
 Bachelors Degree
 Masters Degree

Enter as much information as you can. More details will help us better serve you.
(Salary/Pay per hour: NOT REQUIRED in CA, DE, MA, OR, or NYC)

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


Please CLICK 'SUBMIT YOUR APPLICATION' ONLY ONCE . Depending on your connection speed it may take a few seconds for your computer to cycle to the next screen. Please be patient, the system is processing the application. If you click this button more than once you run the risk of submitting multiple applications.