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CANDIDATE INFORMATION
First Name* :
Middle Initial* :
Last Name* :
Social Security Number* :
Date of Birth* :    
Email Address* :
Home Phone* :
Cell Phone:* :
Street Address* :
City* :
State* :
Zip* :
Have you been convicted of a felony in the past seven years :
   
EMPLOYMENT HISTORY
Most Recent Employer :
Company Location :
Phone Number :
Start & End Date of Employment To
Supervisor :
Position Held & Employment Duties :
Reason for Leaving/Employment Ending :
Was this position offered to you by a staffing company or recruiter? If so, Who? :
   
Next Most Recent Employer :
Company Location :
Phone Number :
Start & End Date of Employment To
Supervisor :
Position Held & Employment Duties :
Reason for Leaving/Employment Ending :
Was this position offered to you by a staffing company or recruiter? If so, Who? :
   
Other Employer :
Company Location :
Phone Number :
Start & End Date of Employment To
Supervisor :
Position Held & Employment Duties :
Reason for Leaving/Employment Ending :
Was this position offered to you by a staffing company or recruiter? If so, Who? :
List other staffing companies and/or recruiters you have worked with & what companies they placed you with :
   
SKILLS & OTHER EXPERIENCE
Please describe any machinery, equipment or tools you have experience using. Also list any software you have used :
   
List any certifications you possess :
   
List any other skills & experience that you have not already listed on this application :
   
EDUCATION & TRAINING
High School :
Diploma :
If no high school diploma, have you obtained your GED :
College :
Dates :
Major :
Type of Degree :
   
College :
Dates :
Major :
Type of Degree :
   
List any special technical or job-related training completed, including work readiness classes :
   

CERTIFICATION & ACKNOWLEDGEMENT

I understand that I am applying for employment through StaffCorp, Inc.  By my signature below, I declare that the information I have provided in the application process is complete, true and correct to the best of my knowledge.  I understand and agree that any false information, omission or misrepresentation, whether discovered before or after a job offer, can result in rejection of my application or termination of my employment. 

 

StaffCorp, Inc. is an Equal Employment Opportunity company.  All qualified candidates will receive consideration without regard to gender, marital status, race, color, age, creed, religion, national origin, veteran status, disability, or any other statutorily protected class or characteristic.

 

I understand that this application form is for use in evaluating my qualifications for employment and is not an offer of or a promise of employment.  A background investigation, interview, various tests and reviews may be required before any final determination of my suitability for employment is made.  All employment at StaffCorp, Inc. is “at will” and is not for any fixed period of time.  If employed, my employment may be terminated by me or by StaffCorp, Inc. at any time, with or without cause.  I understand that approval of my application means only that I am eligible to be employed based on the needs and job openings of a StaffCorp, Inc. client.

 

I agree to submit to a drug test when requested or as required by StaffCorp, Inc. or it’s client’s policy.  I agree to sign any document StaffCorp, Inc. or it’s client may feel is necessary to confirm my consent to drug testing and to release all parties involved in drug testing from any claim or liability arising out of the test or test results.  In addition, I hereby authorize StaffCorp, Inc. and/or it’s client to investigate and make inquiries about my background, including criminal records, and to verify any statements I make during the application process.  I will sign any document StaffCorp, Inc. or it’s client considers necessary to confirm my consent to such an investigation and to release all parties who gather or provide information from any claim or liability.

 

I hereby authorize StaffCorp, Inc. to disclose information on my background and work history, including copies of this Application and any investigation or reference reports to representatives of client companies where I may be considered for assignment or employment.  I hereby release StaffCorp, Inc. and it’s clients, and any persons, employers, companies, agencies and authorities who verify or provide information on my background from any liability for any damage whatsoever for disclosing or issuing any such information.

 

I understand and agree that I may be expected to work in a variety of job assignments in various locations.  As they become available, I agree to accept assignments for which I am qualified in any area where I have indicated a willingness to work.  I specifically understand that if I fail to report for a work assignment or interview without notifying StaffCorp, Inc. in advance, that I am voluntarily quitting and terminating my employment through StaffCorp, Inc.

 

By my voluntary electronic signature below, I acknowledge that I have read and fully understand the Certifications and Acknowledgements above.  I have had the opportunity to ask questions before signing, and all explanations have been in language I understand.

Signature :   Date :
   
 

 

 

 

 

 

 

 

StaffCorp, Inc. is a staffing & recruiting firm that offers employment opportunities for all skill levels. Some advantages to using our company is that all hiring needs are handled under
one roof. Additionally, we offer the most competitive rates in our industry today and all our candidates are backed with a replacement guarantee.