Smarties Agency Job Application Form

Smarties Agency Job Application Form
Email: info@thesmartiesagency.com

Section 1: Personal Information
Full Name*
Date of Birth*

MonthDayYear
Date
Phone Number*
Email Address*
example@example.com
Address*
City/State
Zip*
Section 2: Position & Availability
Position Applying For
Available Start Date

MonthDayYear
Date
Availability (check all that apply):

Full-TimePart-TimeWeekendsOvertime
Section 3: Work Eligibility
Note: Having a criminal record will not automatically disqualify you from employment.

Are you legally eligible to work in the U.S.?Do you have a valid driver's license?Do you have reliable transportation?Do you hold any certifications/licenses?
If yes list
Currently on probation or parole?

YesNo
Convicted of a felony/misdemeanor?

YesNo
If yes list
Currently in a workforce or reentry program?

YesNo
If yes, which one?
Physical restrictions impacting work?

YesNo
If yes explain
Open to training/apprenticeship?

YesNo
Need help with documents(I.D, SScard?

YesNo
Section 4: Education
High School Name
Graduation Year
College or Trade School
Area of Study Degree
Certifications
Section 5: Work Experience
Company Name
Job Title
Responsibilities
Dates Employed

MonthDayYear
Date
Company Name
Job Title
Responsibilities
Dates Employed

MonthDayYear
Date
Section 6: Reference
Reference Name
Relationship
Phone or Email
Section 7: Skills & Training
Are you interested in any of the following training opportunities?

General ConstructionElectricalPlumbingHVACRoofingPainting & FinishesDrywall & FramingHeavy Equipment OperationConcrete & MasonrySite Cleanup & DemoOther
Section 8: Signature & Confirmation

I certify that my answers are true and complete to the best of my knowledge.
Signature*

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Date*

MonthDayYear
Date
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