Staff Inc Employment Application

Staff Inc

Employment Application
APPLICANT INFORMATION
Last Name*
Middle*
First (legal)*
Preferred Name*
Date of Birth*

MonthDayYear
Date
Street Address*
Apartment/Unit #
City*
State*
Zip*
Phone*
Email*
example@example.com
Social Security No.*
In case of emergency notify (name) *
In case of emergency notify (number) *
Are you a citizen of the United States?*

YESNO
If no, are you authorized to work in the U.S.?*

YESNO
EDUCATION HISTORY
High School Attended *
Years Attended *
College Attended*
Years Attended*
PREVIOUS EMPLOYMENT - PLEASE LIST LAST TWO EMPLOYERS
Company Name*
Job Title*
Supervisor Name*
Supervisor Phone #*
Supervisor Email*
example@example.com
From Date*

MonthDayYear
Date
To Date*

MonthDayYear
Date
Company Name *
Job Title
Supervisor Name
Supervisor Phone #
From Date

MonthDayYear
Date
To Date

MonthDayYear
Date
We provide service for many shows attracting Spanish Speaking audiences and providing staff who speak Spanish is of great value to our service goals. Are you fluent in Spanish?*

YESNO
How did you hear about us?*

Current/former Staff Inc employee (list name below)Employment flyerInternetOther
If you selected current/former Staff Inc employee, please indicate name here: Name
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. I authorize investigation of allstatements contained in this application. If this application leads to employment, I understand thatmisrepresentation or omission of facts, is cause for dismissal. Further, I understand and agree that myemployment is for no definite period of time and may be terminated at any time without previous notice.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Staff Inc

APPLICANT INFORMATION

EDUCATION HISTORY

PREVIOUS EMPLOYMENT - PLEASE LIST LAST TWO EMPLOYERS

DISCLAIMER AND SIGNATURE