Employee Application
Last 4 numbers of your SSN:
Salutation:
v
*First Name:
Middle Initial:
*Last Name:
Nickname:
Address:
* City:
* State:
v
* 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:
v
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 
Alabaster
Bessemer
Calera
Cottondale
Downtown
Eastaboga
Homewood
Hoover
Irondale
McCallla
Moody
Pelham
Tarrant
Trussville
Tuscaloosa
Vance

Skill Title 
Yes 
[Collapse]Skill Set: 0001 1
 ABLE TO LIFT 1-25 LB
 ABLE TO LIFT 1-50 LB
 ABLE TO LIFT 1-75 LB
 ASSEMBLY
 BASIC ELECTIRONICS
 BASIC INDUST MATH
 BASIC INDUST SKILLS
 BLUEPRINT READING
 BREAK PRESS
 SUPERVISOR
[Collapse]Skill Set: 0011 2
 CARPENTER HELPER
 CLEAN UP
 COMMERCIAL SEWING
 DRILL PRESS
 ENGINEER
 EXTRUDING
 FOLDER/ENSERTER
 FORKLIFT OPERATOR
 GENERAL LABOR
 HVAC
[Collapse]Skill Set: 0021 3
 HELPER - PAINTER
 HELPER - PLUMBER
 HOUSEKEEPER - HOTEL/
 HVAC
 INJECTION MOLDING
 INSPECTOR
 INVENTORY
 LANDSCAPING
 LATHE
 MACHINE OPERATOR
[Collapse]Skill Set: 0031 4
 MACHINEST
 CNC MACHINEST
 MAINTENANCE - BUILDI
 MAINTENANCE - EQUIPM
 MAINTENANCE - GENERA
 MAINTENANCE - GROUND
 MANAGEMENT
 MATCHING
 MOLD MAKER
 OFFSET PRESS
[Collapse]Skill Set: 0041 5
 OPERATOR - BINDERY M
 ORDER PULLING
 OSHA EXPERIENCE
 PACKAGING
 LOAD/UNLOAD
 CHERRY PICKER
 PLASTIC MOLDING
 JANITORIAL
 PRODUCTION
 PUNCH PRESS
[Collapse]Skill Set: 0051 6
 QUALITY ASSURANCE
 QUALITY CONTROL INSP
 SETTER - MACHINE
 SHIPPING/RECEIVING
 SOLDERING
 STOCK CLERK
 TECHNICIAN
 TOOL & DIE MAKER
 WAREHOUSE EXPERIE
 WELDING

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:
v
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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