*Blue Ribbon: Application

Personal Information

Salutation:

*First Name:

M.I.:

*Last Name:

*Address:

*City:

*State:

*Zip Code:

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:

Position

*What position are you applying for:

Date available for work:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

Minimum rate per hour:

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-to-hire:

Are you available direct-hire:

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 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

To:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

Location

Address:

City:

State:

Zip Code:

Job Information

Supervisor Name:

Supervisor Phone:

Job/Position:

Reason For Leaving:

Employer Information 2

Name of Employer:

Employment Dates

From:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

To:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

Location

Address:

City:

State:

Zip Code:

Job Information

Supervisor Name:

Supervisor Phone:

Job/Position:

Reason For Leaving:

Employer Information 3

Name of Employer:

Employment Dates

From:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

To:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

Location

Address:

City:

State:

Zip Code:

Job Information

Supervisor Name:

Supervisor Phone:

Job/Position:

Reason For Leaving:

Employer Information 4

Name of Employer:

Employment Dates

From:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

To:

September 2023

	Sun	Mon	Tue	Wed	Thu	Fri	Sat
35	27	28	29	30	31	1	2
36	3	4	5	6	7	8	9
37	10	11	12	13	14	15	16
38	17	18	19	20	21	22	23
39	24	25	26	27	28	29	30
40	1	2	3	4	5	6	7

Location

Address:

City:

State:

Zip Code:

Job Information

Supervisor Name:

Supervisor Phone:

Job/Position:

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:

Zip Code:

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:

Zip Code:

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:

Apply For The Job

Certification: I hereby declare that all statements contained in this application are true and correct and I understand that false or inaccurate information in the application may be basis for rejection of this application and or dismissal. I authorize investigation of all statements contained in the application, including my background, which may include criminal background records. I also authorize Blue Ribbon Personnel to release the information contained herein and its findings and work history to other firms or persons as requested. I understand that if employed, my employment is "at-will" and not for any fixed period of time. I understand that "at-will" employment means that either I or Blue Ribbon Personnel may terminate the employment relationship at any time. I also understand that if hired, failure to report for work will indicate that I have quit. If hired, I certify that I am eligible to live and work in the United States and will present evidence of such eligibility in a timely manner.

Please CLICK 'SUBMIT YOUR APPLICATION' ONLY ONCE . Depending on your connection speed it may take a few seconds for your computer to cycle to the next screen. Please be patient, the system is processing the application. If you click this button more than once you run the risk of submitting multiple applications.