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 2020
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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:
Arlington
Conroe
Dallas
Fortworth
Grand Prairie
Houston
Miami
San Antonio
Skills
Skills:
DRIVER : License
DRIVER : CDL-A
DRIVER : CDL-B
DRIVER : CDL-C
DRIVER : Tractor Trailer
DRIVER : Delivery Truck
DRIVER : Delivery Van
DRIVER : Automatic
DRIVER : Clutch
EQUIPMENT : Backhoe
EQUIPMENT : Bulldozer
EQUIPMENT : Outside Forklift
EQUIPMENT : Crane
EQUIPMENT : Drill
EQUIPMENT : Saw
EQUIPMENT : Nail Gun
EQUIPMENT : Jack Hammer
MAINTENANCE : Building Repair
MAINTENANCE : Machinery Repair
MAINTENANCE : FloorCare
MAINTENANCE : Landscape
MAINTENANCE : Lawncare
MAINTENANCE : Hotel Cleaning
MAINTENANCE : Janitorial
SKILLED : Welder
SKILLED : Machinist
SKILLED : Demolition
SKILLED : Supervisor
SKILLED : Carpenter
SKILLED : Construction
SKILLED : Plumber
SKILLED : HVAC
SKILLED : Electrician
SKILLED : Mechanic
SKILLED : Painter
SKILLED : Flagger
SKILLED : Mover
SKILLED : Laundry
SKILLED : Road Crew
SKILLED : Digger/Raker
SKILLED : General Labor
SKILLED : Milwright
SKILLED : Concrete
SUPPLIES AVAILABLE : Hard Hat
SUPPLIES AVAILABLE : Tools
SUPPLIES AVAILABLE : Safety Glasses
SUPPLIES AVAILABLE : Steel Toe Work Boots
SUPPLIES AVAILABLE : Fluorescent Vest
SUPPLIES AVAILABLE : Gloves
WAREHOUSE : Computer Skills
WAREHOUSE : Receiving
WAREHOUSE : Shipping
WAREHOUSE : Load/Unload
WAREHOUSE : Hand Jack
WAREHOUSE : Forklift
WAREHOUSE : Stand Up
WAREHOUSE : Sit Down
WAREHOUSE : Cherry Picker
WAREHOUSE : Inventory
WAREHOUSE : Order Selector
FACTORY : Mechanical Assembler
FACTORY : Electronic Assembler
FACTORY : Solderer
FACTORY : Inspector
FACTORY : Picker/Packer
FACTORY : Quality Control
FACTORY : Machine Operator
FACTORY : Production Line
FACTORY : Production Cell
FACTORY : PC Board Assembler
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 2020
Sun
Mon
Tue
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Sat
36
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31
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40
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41
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To:
September 2020
Sun
Mon
Tue
Wed
Thu
Fri
Sat
36
30
31
1
2
3
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5
37
6
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9
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38
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39
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40
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41
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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 2020
Sun
Mon
Tue
Wed
Thu
Fri
Sat
36
30
31
1
2
3
4
5
37
6
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38
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39
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40
27
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30
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41
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To:
September 2020
Sun
Mon
Tue
Wed
Thu
Fri
Sat
36
30
31
1
2
3
4
5
37
6
7
8
9
10
11
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38
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16
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39
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40
27
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30
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41
4
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8
9
10
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 2020
Sun
Mon
Tue
Wed
Thu
Fri
Sat
36
30
31
1
2
3
4
5
37
6
7
8
9
10
11
12
38
13
14
15
16
17
18
19
39
20
21
22
23
24
25
26
40
27
28
29
30
1
2
3
41
4
5
6
7
8
9
10
To:
September 2020
Sun
Mon
Tue
Wed
Thu
Fri
Sat
36
30
31
1
2
3
4
5
37
6
7
8
9
10
11
12
38
13
14
15
16
17
18
19
39
20
21
22
23
24
25
26
40
27
28
29
30
1
2
3
41
4
5
6
7
8
9
10
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 2020
Sun
Mon
Tue
Wed
Thu
Fri
Sat
36
30
31
1
2
3
4
5
37
6
7
8
9
10
11
12
38
13
14
15
16
17
18
19
39
20
21
22
23
24
25
26
40
27
28
29
30
1
2
3
41
4
5
6
7
8
9
10
To:
September 2020
Sun
Mon
Tue
Wed
Thu
Fri
Sat
36
30
31
1
2
3
4
5
37
6
7
8
9
10
11
12
38
13
14
15
16
17
18
19
39
20
21
22
23
24
25
26
40
27
28
29
30
1
2
3
41
4
5
6
7
8
9
10
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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