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Application For Employment

Advance Services assures equal employment opportunity to applicants and employees in all aspects of personnel administration without regard to political affiliation, race, color, national origin, sex, age, marital status, mental or physical disability, religion, or any other prohibited basis of discrimination, as provided under applicable local, state and federal law.

FEDERAL LAW OBLIGATES US TO PROVIDE REASONABLE ACCOMMODATION TO THE KNOWN DISABILITIES OF APPLICANTS AND EMPLOYEES, UNLESS TO DO SO WOULD POSE AN UNDUE HARDSHIP.  PLEASE LET US KNOW IF YOU NEED AN ACCOMMODATION TO COMPLETE THE APPLICATION PROCESS.

APPLICANT INFORMATION
Nearest Advance Services Location


Applicant's Name (Last, First, Middle Initial)
Street Address
City, State, Zip
1st Phone Number:
Alternate Phone Number:
Email Address

 Date Available For Work
Type of Work Wanted:
Shift Wanted:
Hours needed per week:
If hired, are you able to work more than a forty hour week?
Do you have reliable transportation?
Emergency Contact:
Emergency Number:
 If yes, that number is:
Have you ever worked for another staffing company?
If Yes - Where and when?
EMPLOYMENT RECORD
If you have a resume please attach to this application, and continue by filling in the employment record. Use the browse button below to select a file to attach. Only MS Word and Adobe PDF documents are allowed.
List below the positions you have held, starting with your present employment.  If more than one position or classification has been held with a given organization, list each position or classification as a separate period of employment.  Under "Specific Duties," describe clearly the tasks you performed and the nature of your supervisory, technical, or other responsibilities.  Please be complete.  Your employment history may be verified by contacting previous employers unless you request otherwise.  Volunteer, military, or unpaid experience will be evaluated in the same manner as paid employment and should be entered in the same manner.
Employer #1 (Most Recent)
Employment Information Description of Duties
Employer / Kind of Business
 Position Title
Street Address
 Specific Duties
Immediate Supervisor
 Telephone Number
Dates of Employment (Month/Year)
From:      To:  		Hourly Rate / Salary
Starting: $     Final: $
Reason For Leaving
 
Employer #2
Employment Information Description of Duties
Employer / Kind of Business
 Position Title
Street Address
 Specific Duties
Immediate Supervisor
 Telephone Number
Dates of Employment (Month/Year)
From:      To:  		Hourly Rate / Salary
Starting: $     Final: $
Reason For Leaving
 
Employer #3
Employment Information Description of Duties
Employer / Kind of Business
 Position Title
Street Address
 Specific Duties
Immediate Supervisor
 Telephone Number
Dates of Employment (Month/Year)
From:      To: 		Hourly Rate / Salary
Starting: $     Final: $
Reason For Leaving
 
Training and Work Experience

Please list any types of education, skills, or specialized experience you possess which you feel would be an asset. Exclude names or terms that indicate for example, race, color, religion, sex, disability, or national origin:

EMPLOYMENT SOUGHT

Minimum hourly wage or salary you require
$

Areas / Towns in which you are willing to work
Number of miles you are willing to travel (one way) to assignment
Can you travel if the job requires it?
If Yes - What percentage can you travel
Can you perform the essential job functions with or without reasonable accommodation?
Education / Skills Record
  Name and Location
of School 		Course of Study Did you receive a GED or Diploma?
High School
Vocational / Technical School
College
Have you ever been convicted of a violation of law other than a minor traffic violation?
Can you, after being hired, verify your legal right to work in the United States?
APPLICANT STATEMENT

These answers are true and complete to the best of my knowledge. I understand that any omissions or false information in this application or during the interview process will result in rejection of my application or termination of my employment if hired, regardless of when discovered.

I also understand that any offer of employment may be conditional upon a health evaluation by a doctor selected by Advance Services to determine whether I can perform the essential functions of the job assignment. In addition, I understand a drug or alcohol test may be required, depending upon the client's policy. I authorize Advance Services to make a thorough investigation of my past employment, education, and job-related activities, and I release from "all liability all persons, companies, and corporations providing such information, either in writing or orally. I also indemnify Advance Services, Inc. against any liability that might result from making such investigations. Additionally, I authorize Advance Services to supply my employment record, in its sole discretion, in whole or in part, to any prospective employer, government agency, or other party with an interest that Advance Service. deems appropriate."

Additionally, I understand that nothing contained in this employment application or in the granting of an interview is intended to create a contract between Advance Services and myself for either employment or for the providing of any benefit arising from employment. No promises regarding employment have been made to me. I understand that if an employment relationship is established, I have the right to terminate my employment at any time and Advance Services retains the same right, regardless of any oral representations to the contrary.

** THIS APPLICATION VALID FOR THIRTY (30) DAYS. **

Do not "Agree" and Submit until you have read the above applicant statement.

Please Type your FULL Name (First and Last) Below

By typing AGREE below and submitting this form, I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Type AGREE into the box below if you agree to the terms of this contract:

 

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