Pro-Type Application Form

Employment Application

No applicant or employee will be discriminated against because of race, creed, color, national origin, ancestry, age, sex, marital status, sexual orientation, or physical or mental disability. Our company will adhere to the rules pertaining to the Equal Opportunity and Affirmative Action plans. This application will be active for 90 days from the date below.

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.
Full Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Social Security#:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Position(s) applying for
Minimum acceptable hourly rate
Are you eligible to work in the United States?
Are you available to work?
Have you been convicted of a felony/misdemeanor (other than traffic violations)?
If so, provide the location, date and result/outcome for each conviction:
EDUCATION
Highest level of education completed:

Please complete the appropriate sections

Rows	Name & Location of School	Number of Years Attended	Did You Graduate?	Degree or Certification
GED / High School
Trade School
College
Graduate

WORK HISTORY

Please list your four most recent employers, list the most recent first
1. Employer
Employer's Name (Most current)
Address & location of business
Your title
May we contact this employer?
Reference we can contact

First NameLast Name
Phone number
Format: (000) 000-0000.
Start date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearIf you are unsure of the exact start date, please select the first of the month
End date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearLeave blank if still currently employed
2. Employer
Employer's Name
Address & location of business
Your title
May we contact this employer?
Reference we can contact

First NameLast Name
Phone number
Format: (000) 000-0000.
Start date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearIf you are unsure of the exact start date, please select the first of the month
End date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearIf you are unsure of the exact start date, please select the first of the month
3. Employer
Employer's Name (Third most recent)
Address & location of business
Your title
May we contact this employer?
Reference we can contact

First NameLast Name
Phone number
Format: (000) 000-0000.
Start date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearIf you are unsure of the exact start date, please select the first of the month
End date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearIf you are unsure of the exact start date, please select the first of the month
AUTHORIZATION

I certify that all answers given herein are true and complete to the best of my knowledge. I understand that false, omitted, or misleading information given in the application, or in the application process, may result in cancellation of my application and/or, if hired, may result in my termination. I authorize investigation of all statements contained in this application for employment. I authorize reference checks from all listed employers. I understand this application for employment shall be considered active for a period not to exceed 90 days. I
understand if I am hired, my employment is “at will” and I may resign at any time subject to providing written notice. Pro-Type services may discharge me at any given time, with or without notice, with or without cause. I further understand that this “at will” employment relationship may not be changed except by a written agreement signed by the President of the Company. Furthermore, I understand any offer of employment will be conditioned upon my willingness to be photographed, pass a physical exam, pass a drug screen, and my supplying necessary documents to complete form I-9. Also, I understand that I am required to abide by the policies and regulations of Pro-Type Services.
By entering your name, you agree to accept the terms of the above document with an electronic signature.
You must agree to accept the terms of the document in order to submit an application.
Type signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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