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APPLICATION    Primary Work Preference       Office      Industrial
Name: Last, First, Middle


Address: Street, Apt., City, State, Zip


U.S. Citizen Legal Right to Work in U.S. Social Security Number
Are you presently 18 years of age or older?
Yes No
Home Phone
Other Phone
Referred By Today's Date
In case of Emergency, Notify: Special Emergency Instructions:
Would you be willing to take a drug test if it were a condition of employment? Yes No

Which type of transportation do you use?
Car Available Public Transportation
Have you ever been convicted of a criminal offense other than a minor traffic violation? Yes No
If yes, give details:
Driver's License Number State Expires Class
Check highest level of education Major course of study:
Name, city and state of highest level school attended:
Dates Attended: Degrees Received:

 
Work History
List Current or most recent first
From
To
Employer
Address
Type Business
Position
Phone
Your Duties
Reason for Leaving
May we contact?
Yes No
Your Supervisor's Name
Were you part-time or full-time?
Full-time Part-time
What was your ending pay rate?
 
From
To
Employer
Address
Type Business
Position
Phone
Your Duties
Reason for Leaving
May we contact?
Yes No
Your Supervisor's Name
Were you part-time or full-time?
Full-time Part-time
What was your ending pay rate?
 
From
To
Employer
Address
Type Business
Position
Phone
Your Duties
Reason for Leaving
May we contact?
Yes No
Your Supervisor's Name
Were you part-time or full-time?
Full-time Part-time
What was your ending pay rate?
 
Check the areas below in which you have experience and would like assignments

General Office
Clerk
Receptionist/
      Switchboard
Filing

Equipment
Fax
Phone System
Make, Model & number
of lines:

Typing
General
Forms
Statistical
Legal
Medical

Secretarial
General
Executive
Legal
Medical
Shorthand
Accounting
Payroll
Credit/
      Collections
Payables/
      Receivables
Bookkeeping
Bank Teller

Equipment
Calculator
      Visual
      Touch
Marketing
Sales
Demos
Shopper
Telemarketing
Detailer/
      Merchandiser
Sampler/
      Couponer
Customer
      Service
 
Office Automations
 
Equipment Experience

Software Experience
 

 
For the areas below in which you have experience and would like assignments, note the number of years experience and record any important details in the space provided beside each skill.
 
Industrial Skills

Assembly Line Years Exp. Important Details:
Forklift Years Exp. Important Details:
Inspection Years Exp. Important Details:
Material Handling Years Exp. Important Details:
Stock Clerk Years Exp. Important Details:
Truck Driver Years Exp. Important Details:

Machine Skills

CNC/NC Machinist
      (requiring setup exp)
Years Exp. Important Details:
Machine Operator
      (no setup)
Years Exp. Important Details:
Machinist
Years Exp. Important Details:
Millwright
Years Exp. Important Details:
Printing Press
      Operator
Years Exp. Important Details:
Sheet Metal
      Fabricator
Years Exp. Important Details:
Tool and
      Die Maker
Years Exp. Important Details:


Benchwork Skills

Electronic
     Assembler
Years Exp. Important Details:
Power Hand
      Tools
Years Exp. Important Details:
Semi-Conductor
      Assembler
Years Exp. Important Details:
Soldering/
      Wiring
Years Exp. Important Details:


Structural Skills

Metal Worker
Years Exp. Important Details:

Electrician
Years Exp. Important Details:

Painter
Years Exp. Important Details:

Pipe Fitter
Years Exp. Important Details:

Plumber
Years Exp. Important Details:

Tradesman Helper
Years Exp. Important Details:

Welder
Years Exp. Important Details:

Other Skills

Food Handling
Years Exp. Important Details:

Foreman/Supervisor
Years Exp. Important Details:

Janitor
Years Exp. Important Details:

Landscaping
Years Exp. Important Details:

Mechanic
Years Exp. Important Details:

Other Skills
Years Exp. Important Details:


Other Helpful Skills

Shopmath
Years Exp. Important Details:

Metric Scale
Years Exp. Important Details:

Keyboard
Years Exp. Important Details:

Machime Measure
      Tools
Years Exp. Important Details:

Do you hold a Journeyman License? Yes No      If yes, what trade?

Have you completed a Safety Training Course? Yes No        If yes, when?

What was the name of the course?


Enter your Questions and/or Comments here:



EMPLOYMENT AGREEMENT


I hereby authorize Nan Vaden's Temple Temps to ask the companies and/or persons listed as references on this application any questions concerning me, my work skills, work habits and/or my conduct on the job, unless I have indicated on this application that I do not want the reference to be contacted.

I understand that the term of my employment shall be limited to the length of any temporary assignment I accept and I further understand that Nan Vaden's Temple Temps is not an employment agency. I agree that my employment may be terminated by Nan Vaden's Temple Temps any time without liability of wages or salary except those wages I earned on a temporary assignment prior to my termination.

When employed by Nan Vaden's Temple Temps, I agree that if I make claims against the said Temple Temps for personal injuries at any time, I will submit myself to be examined by a doctor or doctors of Temple Temps choice as often as may be requested.


Submitting this application to Temple Temps via E-mail is the same as signing it and submitting it in person or by mail.

Date submitted: