Employment Application
Fill the form below accurately indicating your potentials and suitability to job applying for.
Name
*
First Name
Last Name
Birth Date
Please select a month
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February
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Month
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Day
Please select a year
2024
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Year
Contact Phone Number
*
Alternative Number
Please enter a valid phone number.
Email
example@example.com
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
JOB SPECIFICATIONS/INFORMATION
Position Applying for:
Company Applying for:
Salary Requirement:
Type of Work Applying for:
FULL TIME
PART TIME
TEMPORARY
SUMMER
Willing to travel?
YES
NO
Referral Source:
Please choose your availability:
Sunday
Wednesday
Monday
Thursday
Tuesday
Friday
Saturday
Available from:
Hour Minutes
AM
PM
AM/PM Option
Available to:
Hour Minutes
AM
PM
AM/PM Option
PROFESSIONAL WORK EXPERIENCE FOR JOB PLACEMENT – LIST NUMBER OF YEARS IN EACH INDUSTRY:
Accounting/Bookkeeping
Carpentry/Drywall
Clerical
Concrete
Construction Labor
Customer Service/Sales
Driving (CDL and Non)
Electrician
Heat/Air Conditioning
Home Health Care
Janitorial
Painting/Taping
Plumbing
Restaurant/Grocery
Roofing
Tile Setting
Welding
Other – List:
PLEASE LIST APPLICABLE SKILLS, LICENSES, CERTIFICATIONS, AND/OR TRAINING:
References
PLEASE LIST YOUR LAST THREE PLACES OF EMPLOYMENT:
Reference 1
Reference 2
Reference 3
Are you legally authorized to work in the United States of America?
YES
NO
APPLICATION ACKNOWLEDGMENT
I certify that all statements and representations made in this application are true and correct and I have withheld nothing which would, ifdisclosed, adversely affect my application. I understand that the Company relies upon such statements in making its employmentdecisions, and I authorize T&T Staff Management, Inc. to investigate all such statements contained therein. I understand and agree thatany misrepresentation will be sufficient cause for cancellation of the application and/or separation from the Company if suchmisrepresentation is discovered at any time after my employment by the Company.I hereby authorize the Company to contact all employers for reference purposes, and I release the Company from any and all liability,including liability arising from the employer's verification of my prior employment history, education, certifications,background screening, references, and any other information. Additionally, I authorize the Company to supply my employment record,in whole or in part, and in confidence, to any prospective employer, government agency, or other party with legal or proper interest. Irelease from any and all liability, including liability arising from negligence, all persons and entities who supply the company withinformation pertaining to my prior employment history, education, certifications, background screening, references, and any otherinformation. Further, if I am employed by the Company, I agree as a condition of continued employment to otherwise fully cooperatewith any internal investigation conducted by the Company.I understand if an employment offer is made, I may need to submit to a drug and/or alcohol test, medical examination, and/orbackground screening. I agree to submit to the requirements and examinations for each exam pertaining to the position.Nothing contained in the employment application shall constitute a contract of employment, and I understand and agree that if I amemployed, such employment will be "at will." In the event of my employment, I will comply with all rules and regulations as set forth bythe Company's Employee Handbook and/or other communications distributed to all employees.I hereby acknowledge that I voluntarily sign and have read and understand the above information.
Applicant Signature
Date
-
Month
-
Day
Year
Date
In Case of Emergency:
First Name
Last Name
Relationship:
Phone Number:
Please enter a valid phone number.
References
Name three (3) individuals we may contact who have knowledge of your performance and work experience, preferably formersupervisors:
Reference 1
Reference 2
Reference 3
Resume and Files
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