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:
November 2024
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Minimum rate per hour:
Days you are available for work:
Mon:
Tue:
Wed:
Thu:
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-to-hire:
Are you available direct-hire:
Cities Will Work:
Cities:
AHOSKIE
AULANDER
AVON
BUXTON
CAMDEN
COFIELD
COLERAIN
COLUMBIA
CONWAY
COROLLA
DUCK
EDENTON
ELIZABETH CITY
EMPORIA VA
ENGELHARD
FRANKLIN VA
GATESVILLE
GRANDY
HARRELLSVILLE
HATTERAS
HERTFORD
KELFORD
KILL DEVIL HILLS
KITTY HAWK
LAWRENCEVEILLE VA
LEWISTON
LOWER CURRITUCK
MANTEO
MOYOCK
MURFREESBORO
NAGS HEAD
PLYMOUTH
POWELLSVILLE
RICH SQUARE
ROANOKE RAPIDS
ROXOBEL
SEVERN
SOUTH HILL VA
SOUTHERN SHORES
STONEY CREEK VA
UPPER CURRITUCK
WANCHESE
WAVES SALVO RODANTHE
WILLIAMSTON
WINDSOR
WINTON
WOODLAND
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, DC, DE, HI, IL, MA, MD, ME, MN, NJ, NY, OR, VT, WA):
Employer Information 1
Name of Employer:
Employment Dates
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November 2024
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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
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November 2024
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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:
November 2024
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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:
November 2024
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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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