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:
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Position
*What position are you applying for:
Date available for work:
February 2025
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Minimum rate per hour:
Days you are available for work:
Mon:
Tue:
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Thu:
Fri:
Sat:
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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-to-hire:
Are you available direct-hire:
Cities Will Work:
Cities:
Harbour Area
Los Angeles
South Bay
West Los Angeles
Skills
Skills:
OFFICE/CLERICAL : RECEPTIONIST
OFFICE/CLERICAL : SWITCHBOARD
OFFICE/CLERICAL : FILE CLERK
OFFICE/CLERICAL : DOCUMENT PREPPER
OFFICE/CLERICAL : COPY/SCAN
OFFICE/CLERICAL : MAILROOM
OFFICE/CLERICAL : POSTAGE METER
OFFICE/CLERICAL : LABEL MAKER
DATA ENTRY/TYPIST : TYPIST 65 WPM
DATA ENTRY/TYPIST : TYPING 45
DATA ENTRY/TYPIST : LESS THAN 45 WPM
DATA ENTRY/TYPIST : NUMERIC/10 KEY
DATA ENTRY/TYPIST : ALPHA/NUMERIC
CUSTOMER SERVICE : CALL CENTER
CUSTOMER SERVICE : INBOUND
CUSTOMER SERVICE : OUTBOUND
CUSTOMER SERVICE : TELEMARKETING
CUSTOMER SERVICE : COLLECTIONS
CUSTOMER SERVICE : HELP DESK
CUSTOMER SERVICE : DISPATCH
CUSTOMER SERVICE : RESERVATIONS
CUSTOMER SERVICE : 440 INSURANCE
ADMINISTRATIVE : EXECUTIVE
ADMINISTRATIVE : CONSTRUCTION
ADMINISTRATIVE : REAL ESTATE
ADMINISTRATIVE : MARKETING
ADMINISTRATIVE : HEALTH CARE
ADMINISTRATIVE : GENERAL
MEDICAL NON CLINICAL : MEDICAL RECORDS
MEDICAL NON CLINICAL : MEDICAL BILLING
MEDICAL NON CLINICAL : ICD-9/ICD-10
MEDICAL NON CLINICAL : CPT
MEDICAL NON CLINICAL : REFERRAL COORDINATOR
MEDICAL NON CLINICAL : CREDENTIALING
MEDICAL NON CLINICAL : FRONT DESK
LEGAL : CRIMINAL
LEGAL : CORPORATE
LEGAL : PROBATE
LEGAL : FAMILY
LEGAL : LITIGATION
LEGAL : IMMIGRATION
LEGAL : PI & INSURANCE
LEGAL : TAX
LEGAL : REAL ESTATE
LEGAL : PARALEGAL
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, DC, DE, HI, IL, MA, MD, ME, MN, NJ, NY, OR, VT, WA):
Employer Information 1
Name of Employer:
Employment Dates
From:
February 2025
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Location
Address:
City:
State:
Zip Code:
Job Information
Supervisor Name:
Supervisor Phone:
Job/Position:
Pay Per Hour:
Reason For Leaving:
Employer Information 2
Name of Employer:
Employment Dates
From:
February 2025
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Location
Address:
City:
State:
Zip Code:
Job Information
Supervisor Name:
Supervisor Phone:
Job/Position:
Pay Per Hour:
Reason For Leaving:
Employer Information 3
Name of Employer:
Employment Dates
From:
February 2025
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Location
Address:
City:
State:
Zip Code:
Job Information
Supervisor Name:
Supervisor Phone:
Job/Position:
Pay Per Hour:
Reason For Leaving:
Employer Information 4
Name of Employer:
Employment Dates
From:
February 2025
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Location
Address:
City:
State:
Zip Code:
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:
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:
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