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(904) 261-5004 from FL

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Please complete the form below:

This application is intended to evaluate your qualifications for employment. This is not an employment contract. It will be kept active for a period of 180 days from this date. After that date, you will be asked to update or submit a new application.

Please fill out completely as the information you provide us will become part of the data base we use to identify candidates for employment.

Name: First
Middle
Last
Nick Name:
Mailing Address:
City/State/Zip:

Phone:

Home
Mobile
E-mail Address:
   
Emergency Contact Information:
Name:
Phone: Home
Work
   
Are you prevented from becoming lawfully employed in this country because of visa or immigration status? Yes No
Are you 18 Years or older? Yes No
Have you applied with us before ? Yes No
     If yes, date:
Are you available to work weekends? Yes No
 

How did you hear about us? ( CTRL + Click to select multiple)

What are the three most important things you've learned in the workplace?
Summarize your work experience. What have you enjoyed the most and least?
 
Education/Training/Certifications (Include institution name,location,course study length & description; degree/certificate/diploma received)
College and/or Other Training
High School
Certifications

Have you ever been terminated, discharged, or asked to resign by a previous employer? Yes No

If yes, give details

Have you ever pled guilty or "no contest" to a crime or been convicted of a crime? (Answering "Yes" to this question is not an automatic bar to employment. Only those crimes that are substantially related to the position you are seeking will be considered.)

Yes No

If yes, give details

   
Driving Information
Do you have a current driver's license: Yes No
State:
Expiration:

Has your driver's license ever been suspended or revoked? Yes No

If yes, please explain the circumstances:

   
PLEASE FILL THIS SECTION OUT COMPLETELY
Work Experience (Most recent employer)
Are you currently working? Yes No
May we contact your employer? Yes No
From: To: Reason for Leaving:
Company: Supervisor:
Address:
City/State/Zip:

Phone:

Office
Fax
E-mail:

Job Title/Description:

Work Experience #2
From: To: Reason for Leaving:
Company: Supervisor:
Address:
City/State/Zip:

Phone:

Office
Fax
E-mail:

Job Title/Description:

Work Experience #3
From: To: Reason for Leaving:
Company: Supervisor:
Address:
City/State/Zip:

Phone:

Office
Fax
E-mail:

Job Title/Description:

 
Select the number of years experience and/or technical training you have for any of the areas below:
Accounting/Bookkeeping:
Bank/Financial:
Bank Teller:
Cash Handling:
Collections:
Construction Office:
Customer Service/Hotel/Hospitality:
Graphic Design:
Human Resources/Personnel:
Insurance Agency:
Legal/Law Office:
Loan/Mortgage Office:
Medical Office:
Medical Billing:
Medical Coding:
Payroll:
Purchasing:
Real Estate/Property Management:
Sales-Inside/Outside:
Tax Preparation:
Title Insurance/Abstracting:
Transcription/Dictaphone:
COMPUTER APPLICATIONS:
Typing:
Data Entry:
Access/Other Database:
Excel/Other Spreadsheet:
Word/Word Perfect:
PowerPoint:
IT(Networks/Programming/ETC.):
QuickBooks/Other Acctg Software:
CAD:
TRADES:
Carpentry:
Electrical/Electronic:
Engineering/Technical:
Machinist - Inside/Outside:
Maintenance/Mechanical:
Planner:
Supply/Inventory/Warehouse:
Welder:
OTHER SPECIAL SKILLS/TRAINING:
Education:
A.A   BS/BA   Masters
Security Clearance:
Multi-Lingual:
Certifications:
Other:
 
Resume

Please email your resume to janderson@satillatemps.com & msanders@satillatemps.com

Verification
The information provided in this application for employment is true, correct and complete.
Initials:
   
Send me a copy of this application.



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