Dial-A-Temp Staffing Service | Application - Dial-A-Temp Staffing Service

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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