Personal Information
Salutation:
*First Name:
M.I.:
*Last Name:
*Address:
*City:
*State:
*Zipcode:
Nickname:
Email:
*How did you hear about us?:
*Home Phone:
Cell Phone:
Other Phone:
Emergency Contact Information
Contact Name:
Contact Phone:
Check if you are legally authorized to work in the United States:
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Position
*What position are you applying for:
Date available for work:
September 2021
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Minimum rate per hour:
Days you are available for work:
Mon:
Tue:
Wed:
Thr:
Fri:
Sat:
Sun:
What shifts you are available to work:
Shift 1:
Shift 2:
Shift 3:
Preferred Shift:
Shift 1:
Shift 2:
Shift 3:
What times are you available to work from:
To:
Checking the below boxes indicates YES:
Do you have transportation:
Will you accept a same day assignment:
Will you accept a long term assignment:
Are you available part-time:
Are you available full-time:
Are you available temp-hire:
Are you available direct-hire:
Cities Will Work:
Cities:
Bryant/Benton
Conway
Jacksonville
Little Rock
Maumelle
Mayflower
Morrilton
North Little Rock
Skills
Skills:
INDUSTRIAL : Cold Environment
INDUSTRIAL : Heat Environment
INDUSTRIAL : Lift 25-50 lbs
INDUSTRIAL : Lift 50-75 lbs
INDUSTRIAL : Lift 75 + lbs
INDUSTRIAL : Have steel-toed boot
INDUSTRIAL : QC / Inspector
INDUSTRIAL : Auto Parts Clerk
INDUSTRIAL : Service Tech.
INDUSTRIAL : Installation Tech.
INDUSTRIAL : Restoration Tech.
INDUSTRIAL : Electrician
INDUSTRIAL : Plumber
INDUSTRIAL : Carpenter
INDUSTRIAL : HVAC
INDUSTRIAL : Boiler/Furnace Oper.
INDUSTRIAL : Janitorial
INDUSTRIAL : Grounds Keeper
INDUSTRIAL : Industrial Painter
INDUSTRIAL : Industrial Sewing
WAREHOUSE : Supervisory Exp.
WAREHOUSE : Lead Experience
WAREHOUSE : WMS Knowledge
WAREHOUSE : Assembly
WAREHOUSE : Shipping/Receiving
WAREHOUSE : Order Selecting
WAREHOUSE : Loader/Unloader
WAREHOUSE : Forklift Certified
WAREHOUSE : Stand Up Lift
WAREHOUSE : Sit Down Lift
MACHINING : Auto Cad
MACHINING : CNC
MACHINING : PLC
MACHINING : Punch Press
MACHINING : Drill Press
MACHINING : Brake Press
MACHINING : MIG Welding
MACHINING : TIG Welding
MACHINING : Flux Core Welding
MACHINING : Blueprint/Schematics
MACHINING/MECHANICAL : Lathe
MACHINING/MECHANICAL : Millwright
MACHINING/MECHANICAL : Plastic Injection
MACHINING/MECHANICAL : Fiberglass
MACHINING/MECHANICAL : Auto Mechanic
MACHINING/MECHANICAL : Diesel Mechanic
MACHINING/MECHANICAL : Heavy Equip. Mech.
MACHINING/MECHANICAL : Trailer Mechanic
MACHINING/MECHANICAL : Maintenance Mechanic
MACHINING/MECHANICAL : Hydraulic/Pneumatics
DRIVING : Class A License
DRIVING : Class B License
DRIVING : Route Driver
DRIVING : End Dump Driver
DRIVING : Dump Truck
DRIVING : Super 10
DRIVING : Boom truck
DRIVING : Box Truck
DRIVING : Heavy Equip Operator
DRIVING : Crane Operator
Previous Employment
Enter as much information as you can. More details will help us better serve you. (Salary/Pay per hour: NOT REQUIRED in AL, CA, CO, CT, DE, HI, IL, MA, ME, NJ, NY, OR, VT, WA):
Employer Information 1
Name of Employer:
Employment Dates
From:
September 2021
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To:
September 2021
Sun
Mon
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Sat
35
29
30
31
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36
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37
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Location
Address:
City:
State:
Zipcode:
Job Information
Supervisor Name:
Supervisor Phone:
Job/Position:
Pay Per Hour:
Reason For Leaving:
Employer Information 2
Name of Employer:
Employment Dates
From:
September 2021
Sun
Mon
Tue
Wed
Thu
Fri
Sat
35
29
30
31
1
2
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36
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To:
September 2021
Sun
Mon
Tue
Wed
Thu
Fri
Sat
35
29
30
31
1
2
3
4
36
5
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37
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40
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Location
Address:
City:
State:
Zipcode:
Job Information
Supervisor Name:
Supervisor Phone:
Job/Position:
Pay Per Hour:
Reason For Leaving:
Employer Information 3
Name of Employer:
Employment Dates
From:
September 2021
Sun
Mon
Tue
Wed
Thu
Fri
Sat
35
29
30
31
1
2
3
4
36
5
6
7
8
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11
37
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38
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39
26
27
28
29
30
1
2
40
3
4
5
6
7
8
9
To:
September 2021
Sun
Mon
Tue
Wed
Thu
Fri
Sat
35
29
30
31
1
2
3
4
36
5
6
7
8
9
10
11
37
12
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14
15
16
17
18
38
19
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22
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25
39
26
27
28
29
30
1
2
40
3
4
5
6
7
8
9
Location
Address:
City:
State:
Zipcode:
Job Information
Supervisor Name:
Supervisor Phone:
Job/Position:
Pay Per Hour:
Reason For Leaving:
Employer Information 4
Name of Employer:
Employment Dates
From:
September 2021
Sun
Mon
Tue
Wed
Thu
Fri
Sat
35
29
30
31
1
2
3
4
36
5
6
7
8
9
10
11
37
12
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16
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38
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21
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25
39
26
27
28
29
30
1
2
40
3
4
5
6
7
8
9
To:
September 2021
Sun
Mon
Tue
Wed
Thu
Fri
Sat
35
29
30
31
1
2
3
4
36
5
6
7
8
9
10
11
37
12
13
14
15
16
17
18
38
19
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21
22
23
24
25
39
26
27
28
29
30
1
2
40
3
4
5
6
7
8
9
Location
Address:
City:
State:
Zipcode:
Job Information
Supervisor Name:
Supervisor Phone:
Job/Position:
Pay Per Hour:
Reason For Leaving:
Temporary Employment
Check if you have ever used a recruiting firm to obtain employment (Temp or Perm):
Agency I
Firm Name:
Address:
City:
State:
Zipcode:
Please list at which clients you were placed, job category, and to whom you reported. Please share your thoughts on the agency and your assignment::
Agency II
Firm Name:
Address:
City:
State:
Zipcode:
Please list at which clients you were placed, job category, and to whom you reported. Please share your thoughts on the agency and your assignment::
Education
High School Education
Name of high school:
High school degree:
High school diploma/certificate:
Business or Other Education
Name of school/program:
School/program degree:
School/program diploma/certificate:
College
Name of college:
College degree:
College diploma/certificate:
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