ProKnee Employment Application

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Full Name* This field is required.
First Name
Middle Name
Last Name
2
Have you ever worked, attained licensing or certification, attended school or been convicted of a criminal offense under a different name?* This field is required.
YESNO
3
If so, what is that name(s)?List all in the field below. If none, leave blank and click NEXT
4
Current Mailing Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country (Scroll to view all options)
5
Phone Number* This field is required.
Area Code
Phone Number
6
Work Phone NumberEnter if applicable. If not, leave blank and click NEXT.
Area Code
Phone Number
7
Email Address* This field is required.
8
Applying for Position* This field is required.Select one from the drop down menu
Please Select
Please Select
Office Assistant/ Customer Service Representative
Production/Product Assembly
9
Are you at least 18 years of age?* This field is required.
YESNO
10
If not 18, what is your birth date:Enter if applicable. If not, leave blank and click NEXT
Date
Year
Month
Day
11
Are you legally authorized to work in the U.S.?* This field is required.
YESNO
12
Are you willing to work:* This field is required.Select all that apply
Monday-Friday
Saturdays
Sundays
Holidays
13
What type(s) of current driver’s license do you have?Select all that apply
None
Maine Class A
Maine Class B
Maine Class C
Out of State Class A
Out of State Class B
Out of State Class C
14
Are you willing to travel on the job?* This field is required.
YESNO
15
If yes, are you willing to use your own vehicle?
Does not apply
Yes
No
16
Are you willing to work overtime?* This field is required.
YESNO
17
What shifts are you willing to work?* This field is required.Select all that apply
1st
2nd
3rd
18
Have you ever served in the U.S. Armed Forces?* This field is required.
YESNO
19
If yes, please fill out the below MILITARY SERVICE RECORD:Enter if applicable. If not, leave blank and click NEXT.
20
ADMINISTRATIVE SKILLSFill out if you would like to be considered for an office position. (Subject to formal testing and work sampling). If not, leave blank and click NEXT.
21
FOREIGN LANGUAGE SKILLSList all languages that apply
Language
Speak
Read
Write
Language 1
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Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Language 2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Language 3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Language 1
Language 2
Language 3
Language
Row 0, Column 0
Speak
Row 0, Column 1
Read
Row 0, Column 2
Write
Row 0, Column 3
Language
Row 1, Column 0
Speak
Row 1, Column 1
Read
Row 1, Column 2
Write
Row 1, Column 3
Language
Row 2, Column 0
Speak
Row 2, Column 1
Read
Row 2, Column 2
Write
Row 2, Column 3
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EDUCATION* This field is required.Fill out all fields that apply
Name
City/State
Last Year Completed
Year Graduated (YYYY)
Achievement
Major
High School
Row 0, Column 0
Row 0, Column 1
1
2
3
4
Row 0, Column 2
Row 0, Column 3
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 0, Column 4
Row 0, Column 5
College or University
Row 1, Column 0
Row 1, Column 1
1
2
3
4
Row 1, Column 2
Row 1, Column 3
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 1, Column 4
Row 1, Column 5
Grad School
Row 2, Column 0
Row 2, Column 1
1
2
3
4
Row 2, Column 2
Row 2, Column 3
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 2, Column 4
Row 2, Column 5
Trade School
Row 3, Column 0
Row 3, Column 1
1
2
3
4
Row 3, Column 2
Row 3, Column 3
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 3, Column 4
Row 3, Column 5
Other
Row 4, Column 0
Row 4, Column 1
1
2
3
4
Row 4, Column 2
Row 4, Column 3
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 4, Column 4
Row 4, Column 5
High School
College or University
Grad School
Trade School
Other
Name
Row 0, Column 0
City/State
Row 0, Column 1
Last Year Completed
1
2
3
4
Row 0, Column 2
Year Graduated (YYYY)
Row 0, Column 3
Achievement
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 0, Column 4
Major
Row 0, Column 5
Name
Row 1, Column 0
City/State
Row 1, Column 1
Last Year Completed
1
2
3
4
Row 1, Column 2
Year Graduated (YYYY)
Row 1, Column 3
Achievement
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 1, Column 4
Major
Row 1, Column 5
Name
Row 2, Column 0
City/State
Row 2, Column 1
Last Year Completed
1
2
3
4
Row 2, Column 2
Year Graduated (YYYY)
Row 2, Column 3
Achievement
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 2, Column 4
Major
Row 2, Column 5
Name
Row 3, Column 0
City/State
Row 3, Column 1
Last Year Completed
1
2
3
4
Row 3, Column 2
Year Graduated (YYYY)
Row 3, Column 3
Achievement
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 3, Column 4
Major
Row 3, Column 5
Name
Row 4, Column 0
City/State
Row 4, Column 1
Last Year Completed
1
2
3
4
Row 4, Column 2
Year Graduated (YYYY)
Row 4, Column 3
Achievement
High School Diploma
GED
Certificate of Completion
Associates Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Row 4, Column 4
Major
Row 4, Column 5
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LICENSE, CERTIFICATION & REGISTRATIONEnter if applicable. If not, leave blank and click NEXT.
24
EMPLOYMENT DESIRED* This field is required.
Please Select
Please Select
Full Time
Part Time
Work Schedule (select one)
Date You Can Start
Salary Desired
Please Select
Please Select
Yes
No
Are you employed now?
Please Select
Please Select
Yes
No
If so, may we inquire of your present employer?
25
APPLICATION HISTORY
Please Select
Please Select
Yes
No
Have you ever applied to this Company before?
Where
When
26
COMPANY HISTORY
Please Select
Please Select
Yes
No
Have you ever worked for this company before?
Where
When
Name of last supervisor at this company
What was your reason for leaving?
27
How did you find out about this position?* This field is required.Scroll to view all options
Employment Agency
Newspaper Ad
Friend/Relative
State Employment Office
College Placement Service
Walk in/Signage on Rt. 17
ProKnee.com
LinkedIn
Facebook
Instagram
Craigslist
Other
Select location from drop down menu
28
EMPLOYMENT HISTORYList your entire work history including part-time, temporary and volunteer jobs. List jobs in reverse order, starting with your present or last job. List each promotion as a separate job. To evaluate your qualifications we must have accurate and complete information on previous job task and levels of responsibility. Be thorough and specific in the detailing of duties.
29
In addition to your work history, are there other skills, qualifications or experiences that you would like us to consider?
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Small
Ok
Ok
30
Signature* This field is required.Use mouse or finger to sign on the line below.
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31
Please select the date this application was signed:* This field is required.
Date
Year
Month
Day
32
Upload Resume*Required for OFFICE ASSISTANT/ CUSTOMER SERVICE REPRESENTATIVE position.
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