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Today's Date:

Last Name:

First Name:

Middle Initial:

Primary Phone (home):

Secondary Phone (cell):

Email:

Street Address:

City:

State:

ZIP:

When can you start?

Desired Wage:

ACKNOWLEDGE AND CONFIRM THAT I AM A U.S. CITIZEN OR AM OTHERWISE AUTHORIZED TO WORK IN THE UNITED STATES ON AN UNRESTRICTED BASIS (documentation may be required).

I ACCEPT and ACKNOWLEDGE the above statement. *

Position(s):

If you selected "Other" please describe:

If part-time, what days/hours are you available?

What shift(s) are you available to work?

Day Shift
Evening Shift
Overnight Shift
Rotating Shift

Are you available for weekends?

Yes
No

How did you hear about us?

I have been convicted of a felony. (answer will not necessarily affect your application).

Yes
No

If you answered "Yes" to the previous question, use the space below to provide any details.

Education

High School

High School:

Year Graduated:

I did not finish high school but have a GED:

Yes
No

College

College:

Year Graduated:

Degree:

Major:

Other

Other (Professional or technical training/schooling):

Year Graduated:

Degree:

Major:

Please add any specific skills, qualifications or experience which will help us find the best jobs for you:

Employment History

Start with most recent employer

Employer One

Company:

Name of Supervisor:

Phone

May we contact?

Yes
No

Date Started:

Date Ended:

Starting Wage:

Ending Wage:

Starting Position:

Responsibilities:

Reason(s) for leaving:

Employer Two

Company:

Name of Supervisor:

Phone

May we contact?

Yes
No

Date Started:

Date Ended:

Starting Position:

Responsibilities:

Starting Wage:

Ending Wage:

Reason(s) for leaving:

Employer Three

Company:

Name of Supervisor:

Phone

Starting Wage:

Ending Wage:

May we contact?

Yes
No

Date Started:

Date Ended:

Starting Position:

Responsibilities:

Reason(s) for leaving:

I CERTIFY THAT THE FACTS SET FORTH IN THIS APPLICATION FOR EMPLOYMENT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT IF I AM EMPLOYED, FALSE STATEMENTS ON THIS APPLICATION SHALL BE CONSIDERED SUFFICIENT CAUSE FOR DISMISSAL. SOUTHEAST STAFFING, INC. IS HEREBY AUTHORIZED TO MAKE ANY INVESTIGATIONS ON MY PERSONAL INFORMATION, PRIOR EDUCATIONAL AND EMPLOYMENT HISTORY PROVIDED ABOVE.

I ACCEPT and ACKNOWLEDGE the above statement. *

I ACCEPT and ACKNOWLEDGE the above statement. *

EMPLOYMENT AT SOUTHEAST STAFFING, INC. IS "AT WILL," WHICH MEANS THAT EITHER I OR SOUTHEAST STAFFING, INC. CAN TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, WITH OR WITHOUT PRIOR NOTICE, FOR ANY REASON NOT PROHIBITED BY STATUTE. ALL EMPLOYMENT IS CONTINUED ON THAT BASIS. I UNDERSTAND THAT NO SUPERVISOR, MANAGER OR EXECUTIVE AT SOUTHEAST STAFFING, INC., OTHER THAN THE PRESIDENT, HAS ANY AUTHORITY TO ALTER THE FOREGOING.

Year Position(s): we

I ACCEPT and ACKNOWLEDGE the above statement. *

First Choice

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Application for Employment

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Education

High School

College

Other

Employment History

Employer One

Employer Two

Employer Three