EMPLOYMENT APPLICATION

Thank you for taking the time to complete our online employment application. You will be asked questions about job interests, availability, education and work experience. 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
Are you willing to take a drug test?
Yes No
 
First Name (Required)
Middle Name
Last Name (Required)
Nickname / Preferred Name
Street Address / Apartment  
City
State / ZIP Code    
Home Phone (Required) - Area code and phone number
Other Phone - Area code and phone number
Email Address
Resume - If you have a plain-text resume, paste it into the box below.
 

Availability

Are you interested in temporary positions?
Yes No
Are you interested in career positions?
Yes No
Are you interested in contract positions?
Yes No
When are you available to start?
What weekday hours are you available?
What weekend hours are you available?
Are you willing to work overtime?
Yes No
What is the minimum pay that you will work for?  (Hourly Rate or Annual Salary)  
If we offer you an assignment, how soon would you be able to start work?
How long would you like your new job assignment to last?
How many miles (from your house) would you be willing to travel to get to work?
How many hours are you willing to work in a week?
What type of work are you looking for?

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
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
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 the answers given are true and correct.  I understand that making false statements or omitting pertinent facts is sufficient cause for rejection or dismissal from employment or consideration.  I authorize Corbett Personnel to verify the above information, to conduct a background check of me as a candidate for employment, and to present their results to prospective employers or customers.

I understand that a reference check by a staffing service qualifies as an "investigative consumer report" under the Fair Credit Reporting Act.  Such reports include information about a consumer's character, general reputation, personal characteristics, and mode of living (whichever are applicable) obtained through personal interviews with sources like neighbors, friends or associates.

I understand that I have the right to make a written request within a reasonable time to receive a complete and accurate disclosure of the nature and scope of such an investigation, if one is made.  I will notify Corbett Personnel whenever I am offered employment by any company or their affiliates, divisions, associates or other entities within six (6) months after completion of my assignment or interview.

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:    


This Company 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 Company depends solely on your qualifications.