| |
| United
Employment Services is an equal opportunity employer and will not
discriminate against any applicant on the basis of any characteristic
that is protected by State or Federal law. Michigan law requires
that a person with a disability or handicap requiring accommodation
to perform the essential duties of the job must notify the employer
in writing within 182 days of the date the need is known or should
have been known. |
| Date
of Application: |
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| Last
Name: |
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| First Name: |
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| Middle Initial: |
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| Social Security
#: |
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| Home Phone: |
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| Cell Phone: |
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| Address 1: |
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| Address 2: |
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| City: |
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| State: |
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| Zip: |
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| Are
you 18 years or older?
Yes
No |
| Have
you been employed in the last 6 months?
Yes
No |
| Salary
Desired:
|
| Type
of Employment:
Full Time
Part Time |
| Date
you can start:
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| Have
you ever applied to this company before?
Yes
No |
| Do
you have reliable transportation?
Yes
No |
| Drivers
License Number:
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| Special
Licenses:
CDL
Chauffeur's |
| Are
you authorized to work in the United States?
Yes
No |
| Have
you ever been convicted of a felony?
Yes
No |
| If
so, please state citation, date and place where offense occurred:
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| Have
you ever served in the Armed Forces of the United States, National
Guard or Reserves?
Yes
No
Branch:
Rank:
Date of Discharge:
Special/Technical
Military Training:
|
| Please
provide any additional information such as special skills, training,
management experience; equipment operation or qualifications you
feel will be helpful to us in considering your application:
|
| Education: |
Elementary
School:
Name and Location
of School
|
| High
School:
Name and Location
of School:
Number of years
Attended
Did you graduate?
Yes
No |
| College:
Name and Location
of College:
Number of years
Attended
Did you graduate?
Yes
No
Subject/Major:
|
| Name
and Location of College:
Number of years
Attended
Did you graduate?
Yes
No
Subject/Major:
|
| References: |
| Name:
Address:
Phone:
Years Acquainted:
|
|
Name:
Address:
Phone:
Years Acquainted:
|
|
Name:
Address:
Phone:
Years Acquainted:
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| Current
and Former Employers: (
Most Recent First) |
| Date
of Employment:
From:
Month:
Year:
To:
Month:
Year:
Employer Name:
Employer Address:
Employer Phone:
Position Held:
Responsibilities:
Starting Salary:
Ending Salary:
Reason for Leaving:
|
| Date
of Employment:
From:
Month:
Year:
To:
Month:
Year:
Employer Name:
Employer Address:
Employer Phone:
Position Held:
Responsibilities:
Starting Salary:
Ending Salary:
Reason for Leaving:
|
Date
of Employment:
From:
Month:
Year:
To:
Month:
Year:
Employer Name:
Employer Address:
Employer Phone:
Position Held:
Responsibilities:
Starting Salary:
Ending Salary:
Reason for Leaving:
|
Date
of Employment:
From:
Month:
Year:
To:
Month:
Year:
Employer Name:
Employer Address:
Employer Phone:
Position Held:
Responsibilities:
Starting Salary:
Ending Salary:
Reason for Leaving:
|
| Date
of Employment:
From:
Month:
Year:
To:
Month:
Year:
Employer Name:
Employer Address:
Employer Phone:
Position Held:
Responsibilities:
Starting Salary:
Ending Salary:
Reason for Leaving:
|
| May
we contact employers listed?
Yes
No |
| Skills |
| Trades |
Computer: |
|
Assembly |
Data Entry |
|
Blueprint Reading |
Graphic Design |
|
Calipers |
Internet |
|
Carpentry |
Macintosh |
|
CNC |
PC |
|
Die Cast |
Programming |
|
Electrical |
Publishing |
|
Fabrications |
Spreadsheets |
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Fork Lift |
Web Design |
|
Injection Molding |
Other:
|
|
Machinist |
|
|
Maintenance |
Software: |
|
Mechanical |
Java Script |
|
Mics |
Lotus 1-2-3 |
|
Plumbing |
MS Access |
|
Q. A. Inspection |
MS Outlook |
|
Screw machine |
MS Power Point |
|
Spot Welding |
MS Publisher |
|
Tool Maker |
MS Word |
|
Welding |
MS Works |
| Other:
|
Windows OS |
|
Other:
|
| Support: |
|
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Cleaning |
Bookkeeping: |
|
Home Care |
Accounts Payable |
|
Landscaping |
Accounts Receivable |
| Other:
|
Payroll |
| |
Peachtree |
| Office: |
Posting |
|
Cash Register |
Quick Books |
|
Copy & Fax |
Other:
|
|
Customer Service |
Other
achievements, skills, characteristics or activities:
|
|
Filing/Clerical |
|
Multi-Line |
|
Transcribing |
|
Typist WPM
|
| Other:
|
| Please
read the following statement carefully before signing to indicate
your understanding…
I understand that, prior to being offered
employment, I may be requested to take an employment examination.
In the event that I have a disability that will affect my
ability to take the test, I will so inform the Company prior
to the test so that a reasonable accommodation can be made.
The Company reserves the right to require medical documentation
regarding the need for accommodation.
I certify that the facts contained in this
application are true, accurate, and complete to the best of
my knowledge and understand that, if employed, falsified statements
or omitted material facts on this application may result in
my disqualification from consideration for employment, or
termination from employment if I have been hired.
I understand and agree that, if hired, my
employment is for no definite period and may, regardless of
the date of payment of my wages and salary, be terminated
with or without cause, at any time, with or without notice.
This provision supersedes any oral or written representation
to the contrary unless in writing and signed by both the President
of the Company and the person to whom the writing is directed.
I
authorize investigation of all statements contained in this
application for any employment-related purpose. I release
the listed references and all employers, except those specifically
expected to provide you with any and all applicable information
that may have. I hereby release these references and former
employers from all liability for any information that may
give to the Company.
I accept these terms.
I do not accept these terms
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