Dial-A-Temp Staffing Service
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Job Application
NOTE: all *astricks are required information. These MUST be filled in to submit the form.
SECTION I: APPLICANT INFORMATION
*
Indicates required field
Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Are you presently employed?
*
Yes
No
Date available to work?
*
Phone Number
*
Email
*
Shift Preferred:
*
Pay Desired:
*
Have you ever applied for employment at Dial-A-Temp before?
*
Yes
No
If yes, when & to which company did we place you?
*
Are you at least 18 Year of age?
*
Yes
No
Are you legally eligible for employment in the U.S.?
*
Yes
No
SECTION II: CRIMINAL HISTORY
Have you ever been convicted of a felony or misdemeanor?
*
Yes
No
If yes, please explain:
*
SECTION III: EMPLOYMENT HISTORY (Please list most recent first)
1. Employer Name & Address & Job Title (Most Recent)
*
Hire Date:
*
Termination Date:
*
Job Duties & Hourly Rate:
*
Reason for leaving:
*
2 Employer Name & Address & Job Title (2nd Most Recent)
*
Hire Date:
*
Termination Date:
*
Job Duties & Hourly Rate:
*
Reason for leaving:
*
SECTION IV: EDUCATION HISTORY
High School GED/Diploma?
*
Yes
No
Special Qualifications/Skills? List here:
*
By submitting this form (serves as electronic submission/signature), I acknowledge that all the information provided is true. Falsifying information may lead to immediate termination and no future employment with Dial-A-Temp.
CLICK SUBMIT TO SEND APPLICATION:
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