Personal Information (Step 1)


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Convertir la aplicación al español		  
The application will convert most entries to capital letters
Are you at least 18 years of age and do you have the legal right to work in the United States?  (Required)
Yes No
Are you willing to take a drug test?
Yes No
 
First Name  (legal name) (Required)
Middle Name
Last Name (Required)
Nickname / Preferred Name
Residence Address / Apartment (No PO Box)  
Residence City
Residence State / ZIP Code    
    
Home Phone 1---
Other Phone or Cell 1---
     
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TAX COLLECTING INFORMATION (Step 2)
Please enter your social security number. Please note your social security number is used for 1st Choice Personnel purposes only.
     
Social Security Number#
  

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1st Choice Personnel safeguards confidential information concerning applicants, employees, Enrollment Services business, and other matters. Unauthorized access and/or disclosure of confidential information is prohibited.
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Federal Tax Withholdings (Step 3)
     
Federal Filling Status   
Federal Exemptions Enter "1" for yourself if no one else can claim you as a dependant.
Any Additional Withholdings
     
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Conviction History (Step 4)

Note: I understand that any misrepresentation or omissions may result in my termination regardless of the time of discovery.  A prior conviction will not necessarily bar you from employment.  The type and recently of the conviction will be considered. 

Have you ever been convicted of an offense other than a minor traffic violation? (Required)

Yes                    No
If yes, please complete the following:
Month/Year:  
Offense Details:
Are you bonded?

Enter the date of your bonding.

 
Yes No

  Day Year

Bonding Details
 
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Availability (Step 5)

Are you willing to work temporary?
Yes No
Are you looking for a full-time career position?
Yes No
Are you looking for contract positions?
Yes No
When are you available to start work?
What weekday hours are you available?
What weekend hours are you available?
How many hours are you willing to work in a week?
Are you willing to work overtime?
Yes No
What is the minimum pay you desire? Hourly rate or annual salary
How much notice will you need if a position is offered to you?
How many miles are you willing to travel to a position?
     
   

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Driving Information (Step 6)
I have a valid Drivers License
Yes No
License Number and State ST. 
I Drive my Own Vehicle
Yes No
I Rely on others for transportation
Yes No
 
     
   

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Resume (Step 7)
Resume - If you have a plain-text resume, paste it into the box below.
 

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Education (Step 8)

Enter most recent - Do not enter start and end date if the most recent is high school
Don't remember your schools address? Click here to look it up.
Name of School
Type of school
Street Address
City  
State / ZIP Code  
Start Date (Month / Year)  
End Date (Month / Year)  
Degree
Major Study Area
Other Studies
   

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Recent Employment (Step 9)

Don't remember your works address? Click here to look it up.
List most recent first. (Enter a least one previous employer)
Company Name
Street Address
City
State / ZIP Code  
Phone Number - Area code and phone number
Supervisor Name
Job Title  
Job Duties  
Start Date (Month / Year)    
End Date (Month / Year)  
Start Wage   Hourly rate or annual salary
End Wage   Hourly rate or annual salary
Reason for leaving  
May we contact this employer for a reference check?
Yes No
Company Name
Street Address
City
State / ZIP Code  
Phone Number - Area code and phone number
Supervisor Name
Job Title  
Job Duties  
Start Date (Month / Year)  
End Date (Month / Year)
Start Wage   Hourly rate or annual salary
End Wage   Hourly rate or annual salary
Reason for leaving  
May we contact this employer for a reference check?
Yes No
 

Temporary Service Employment

List your most recent Temporary Agency worked for (if any) Skip Step
Don't remember temp service address? Click here to look it up.
Company Name
Street Address
City
State / ZIP Code  
Phone Number - Area code and phone number
Supervisor Name
Job Title  
Job Duties  
Start Date (Month / Year)  
End Date (Month / Year)
Start Wage   Hourly rate or annual salary
End Wage   Hourly rate or annual salary
Reason for leaving  
May we contact this employer for a reference check?
Yes No
   

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SKILLS SECTION (Step 10) Enter All Your Skills

Select one of the options below.
View all skills  View Computer/Clerical skills  View Industrial Skills
 
 
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Skills - Office / Clerical (Step 10)
Place a check mark on your skills
 Back
Clerical-Please note details about your skills will be done during the interview process
Secretary             C020
Word Processor   C021
General Office C022
Receptionist C023
Professional- If you have some additional professional skills such as computer, database, administrative office then select this option. Further details about your skills will be gathered during the interview process. C024
 
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Skills - Industrial
Place an check mark on your skills
Back
General Laborer-Heavy Lifting -Up to 75lbs  I026
General Laborer-Lite Lifting -Up to 25lbs  I027
General Assembly Heavy Lifting -Up to 75lbs  I028
General Assembly Lite Lifting -Up to 75lbs I029
Forklift Certified I030
Machine Operator I030
Welder I031
Other Technical Skills I032
 
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PLEASE READ and Initial Below indicating you have read this statement.

I certify the statements I have made are true and correct and without material omission. I understand that making false statements or omitting pertinent facts is sufficient cause for rejection or dismissal from employment. I authorize obtaining information from any person(s), employers, educational institutions, licensing authorities, and/or law enforcement agencies concerning my background, work habits, skill or conduct on the job, with the exception of past employer(s) I have indicated that are not to be contacted. I hereby release such person or entities from all liability for damages for issuing such information.

I do hereby give my consent to 1st Choice Personnel and any medical testing laboratory or clinic designated by 1st Choice to perform appropriate tests or examinations on me including, but not limited to, urine or blood testing for illegal, controlled, or unauthorized substances or alcohol.  I also agree to take any physical examinations or medical tests now or at a later time that 1st Choice may require for the health or safety of its employees including, but not limited to, testing for illegal, controlled, or unauthorized substances or alcohol. 

I agree to release and hold harmless 1st Choice Personnel, its agents and employees from any and all liability and damages resulting or arising from any medical test or physical examination or 1st Choice Personnel's reliance on same, or in connection with any action taken by 1st Choice in reliance upon the test or examination results, or from the release of the results of any such test or examination.  I understand that this authorization, consent and release is of a continuing nature and shall continue from this date throughout any employment with 1st Choice.  (For current employees, this consent form will be on file at medical treatment facilities.)

If employed, I agree that if at any time I shall make claims against the company for personal injuries, upon written request I will submit myself to examination by a physician or physicians of the company’s selection (at company’s expense) as often as may be requested. 

On occasion, a 1st Choice Personnel customer may wish to hire an employee who has been assigned from our office.  1st Choice Personnel employees will normally work a predetermined number of hours as a 1st Choice employee before being considered for any regular positions that may be open with our customers.  NOTE:  Our customers are aware of this option to hire 1st Choice employees after they have worked a predetermined number of hours.  Many positions our employees fill are considered long-term or indefinite positions for 1st Choice employees only.  For that reason, those positions may not be filled by regular employees.  Our goal is to provide the very best employees to our customers so our customers can meet their goals.

I have read and understand 1st Choice Personnel's policy on hiring 1st Choice employees and 1st Choice Personnel's employee agreement.  Also to the best of my knowledge all information that I have provided on this employee record is true, correct and complete.  I understand that misrepresentation or omissions may result in my termination, regardless of the time of discovery.

Please take a moment to review your application.  Indicate that you have read the above statement by entering your initials in the box below.  To complete this application, click on the Submit Application button.
Initials:     (Please only click Submit once) 
1st Choice Personnel is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this 1st Choice Personnel depends solely on your qualifications.