Stetzner Staffing Application

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Stetzner Staffing Application
Applicant Information
Full Name*
First Name
.
Middle Initial (if any)
Last Name
Full
Full Reversed
Preferred Name
Social Security Number*
Without dashes
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone*
Please enter a valid phone number.
Email
example@example.com
Date of Birth*

MonthDayYear
Do you have a reliable vehicle?
Are you authorized to work in the U.S.?*
Did you serve in the United States Military?
Branch
Highest Rank
How did you hear about us?
Help us be an equal opportunity employer: You are requested but not required to fill in the personal data below. Information will only be used for government reporting purposes and not as selection criteria for the hiring process.
Ethnicity
Gender
Skills & Certifications
Please list any skills or certifications you have.
Education
High School
Name of institution
Degree
Did you graduate?
College
Name of institution
Degree
Did you graduate?
Trade School/Other
Name of institution
Degree
Did you graduate?
Previous Employment

Please list from most current to oldest.
Employer Name
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving?
Employer Name
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving?
Employer Name
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving?
Have you previously worked for Stetzner Staffing LLC?*
Have you ever worked/applied with a staffing agency before?
If yes, please state where
Resume?

YesNo
Upload Resume

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Professional References

Please list three professional references.
Reference #1

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Reference #2

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Reference #3

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Disclaimer

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature*

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Date*

MonthDayYear
Should be Empty:

Applicant Information

Education

Previous Employment

Professional References