Contractors Employment Service       
Application for Employment

Applicant Note:  This application form is used in evaluating your qualifications for employment.  This is not an employment contract.  Please answer all appropriate questions completely and accurately.  False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment.  Qualified applicants will receive consideration without discrimination based on sex, marital status, race, color, age, creed, national origin, sexual orientation, military reserve membership, ancestry, religion, height, weight, use of a guide or support animal because of blindness, deafness or physical handicap, or the presence of disabilities.  A conviction will not necessarily bar an applicant from employment.  Additional testing of job-related skills may be required prior to employment.  After an offer of employment, and prior to reporting to work, you will be required to take a Urinary Analysis for controlled substances.

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Please provide the following contact information:
  First Name
Middle  
Last Name
Street Address
City
State/Province
Zip/Postal Code
Home Phone
FAX
E-mail
Enter your Social Security # in the space provided 
 
What kind of Work are you Looking for?  
 
When can you Start Work?     -- mm/dd/yy
 
Do you have a valid Drivers License?  Yes No
   DL#       Class    State of Issue:
 
Have you had any moving violations within the last seven years?   Yes No
If "Yes" please describe:


Have you ever been convicted of a crime in the past seven years?  Yes No
Year of Incident:    
City/State:
Charge:
Comments:


Most Recent Employer:
Organization     
Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
Dates Employed:
Job Title & Duties:
Reason for Leaving:
 
Second most Recent Employer:
Organization
Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail
Dates employed:  
Job Title & Duties:
Reason for Leaving:
 
Third most recent Employer:
Organization
Name
Title
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
Dates employed:    
Job Title and duties:
Reason for Leaving:
 
References: Include only individuals familiar with your work ability - DO NOT INCLUDE RELATIVES!
Name
Street Address
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
Name
Street Address
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
After completion of this application you will be contacted by our office for an interview. This interview will be conducted in our offices. Please bring with you a Photo ID and Proof of Eligibility to work in this Country such as a Social Security Card or Birth Certificate with you at that time. Thank you!

Copyright 2006 [Contractors Employment Service]. All rights reserved.
Revised: March 19, 2008