GPS - DSP Employment Application Form

GUIDANCE & PRODUCTIVITY
STAFFING SOLUTIONS SERVICES LLC
EMPLOYMENT APPLICATION

GPS SOLUTIONS SERVICES LLC is an equal opportunity employer. Applicants will be considered regardless of race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status. Equal access to the hiring process, services, and employment is available to all individuals. Applicants requiring accommodations to the application and/or interview process should contact the GPS SOLUTION SERVICES LLC.

Each question should be answered completely and accurately.

No action will be taken on this application until all questions have been answered and the application has been signed and dated. Verification of eligibility to work in the U.S. will be required if an employment offer is made.
APPLICANT NAME*

First NameMiddle NameLast Name
We collect date of birth and gender information for demographic and diversity reporting purposes. This information is optional, and you are not required to provide it. If you choose to disclose, rest assured that your personal information will be handled with the utmost confidentiality and in compliance with privacy laws. Providing this information is entirely voluntary and will not impact your application process. Thank you for helping us create a more inclusive workplace.
DATE OF BIRTH

MonthDayYear
Date
GENDER
CURRENT ADDRESS*

Street Address

Street Address Line 2

CityState

Zip Code
PHONE NUMBER*
E-MAIL*
example@example.com

EDUCATION

Use the "Add" button to add additional education entries.
HIGHEST LEVEL OF EDUCATION COMPLETED:*
CERTIFICATES (i.e. CPR, SCIP-R, AMAP, etc.)

Please provide a list of relevant certificates you hold. Include the name of the certificate, the date of issuance and and the expiration date if applicable. Use the "Add" button to include additional certificates.

WORK HISTORY

Provide complete information for your past 2 employers. Start with your present or most recent job.
1. EMPLOYER
EMPLOYER'S NAME (Most current)
BUSINESS ADDRESS
JOB TITLE
MAY WE CONTACT THIS EMPLOYER?

YESNO
SUPERVISOR'S NAME
First and Last Name
SUPERVISOR'S PHONE NUMBER
EMPLOYMENT START DATE

MonthDayYear
Date
EMPLOYMENT END DATE

MonthDayYear
Leave blank if current job
JOB RESPONSIBIITIES (Be specific. Describe your major job duties and responsibilities):
2. EMPLOYER
EMPLOYER'S NAME (Most current)
BUSINESS ADDRESS
JOB TITLE
MAY WE CONTACT THIS EMPLOYER?

YESNO
SUPERVISOR'S NAME
First and Last Name
SUPERVISOR'S PHONE NUMBER
EMPLOYMENT START DATE

MonthDayYear
Date
EMPLOYMENT END DATE

MonthDayYear
Leave blank if current job
JOB RESPONSIBIITIES (Be specific. Describe your major job duties and responsibilities):
REFERENCES

List two references that are familiar with your work (present/former employer or colleague)
1. FULL NAME

First NameLast Name
COMPANY
PHONE NUMBER TO REACH THEM
2. FULL NAME

First NameLast Name
COMPANY
PHONE NUMBER TO REACH THEM
OPTIONAL SECTION
UPLOAD YOUR RESUME, CLICK "CHOOSE FILE

Cancelof
UPLOAD A COVER LETTER, CLICK "CHOOSE FILE"

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YOU MUST AGREE TO ACCEPT THE TERMS OF THE DOCUMENT IN ORDER TO SUBMIT AN APPLICATION
I certify that the information contained in this application is true and complete.*

I certify that the information contained in this application is true and complete.I authorize investigation of all statements contained in this application for employment as may be necessary for arriving at an employment decision.In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.
Signature

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Date*

MonthDayYear
Date
Should be Empty: