Employment Application

Apply for a Job through Action Associates

Thank you for taking the time to complete our online employment application. Please fill out the application below as completely as possible. This application will take approximately 15 minutes to complete.

Personal Information

Are you at least 18 years of age and do you have the legal right to work in the United States? Yes No First Name: * Middle Name: Last Name: * Nickname / Preferred Name: Street Address: Apartment: City: State: Zip Code:

Home Phone: -*

Other Phone: -

Email Address: Resume: If you have a plain-text resume, paste it into the box below.

Availability

Are you willing to work temporary assignments? 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?

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? What type of work are you interested in?

Education

Enter most recent - Do not enter start and end date if the most recent is high school

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:

Recent Employment

List most recent first

Company Name: Street Address: City: State: Zip Code: 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 May we contact this employer for a reference check? Yes No

Employment History 2

Company Name: Street Address: City: State: Zip Code: 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 May we contact this employer for a reference check? Yes No

Employment History 3

Company Name: Street Address: City: State: Zip Code: 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 May we contact this employer for a reference check? Yes No

I certify that answers given herein are true and complete to the best of my knowledge.

I understand that falsification of any information on my employment application would constitute grounds for immediate dismissal.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed six months. Any applicant wishing to be considered for employment beyond this time period, should inquire as to whether applications are being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing.

In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

I understand that I am applying for temporary, temp to hire or direct hire positions. The completion of the this application process shall constitute a conditional offer of employment subject to my availability and the availability of customer assignments calling for the skill and qualifications that I possess, and I agree to consider acceptance of such assignments.

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:

Action Associates is committed to providing Equal Employment Opportunities (EEO) to all qualified persons regardless of race, color, sex, religion, sexual orientation, national origin, citizenship, age, handicap, height, weight, veteran or marital status, or any other protected category.

Apply for a Job through Action Associates

Personal Information

Availability

Education

Recent Employment

Employment History 2

Employment History 3

Skills

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