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Recruiting and Temporary Employment Services

Application for Employment

Required fields are indicated by an *.

Personal Information

*First Name:

*Middle Name:

*Last Name:

*Address:

*City:

*State:

*Zip Code:

*Email Address:

*Home phone:

*Mobile phone:

*Social Security Number:

Date of Birth:

Have you ever applied for employment with us?

Yes No

If Yes, what Month/Year:

Position Desired:

Pay Expected:

Apart from absence for religious observance, are you available for full-time Work?

Yes No

Will you work overtime?

Yes No

Available Date:

How did you learn of our organization?

Other special Training or skills (Language, machine operation, Etc.)

Are you legally eligible to work in the United States?

Yes No

Are you A U.S. Citizen?

Yes No

Language Skills:

Bilingual

*Do you speak at least 50% English?

Yes No

*Do you read at least 50% English?

Yes No

Please mark the locations where you are willing to work in:

Dalton Chatsworth Chattanooga

Please indicate which shift you are available for:

1st 2nd 3rd SWING SHIFT
ANY

Have you ever been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by a court?

Yes No

If Yes, describe in full.

State names of relatives and friends working for us other than your spouse.

Have you received Workman's Compensation or Disability Income Payments?

Yes No

If Yes, describe.

Do you have any physical defects which preclude you from performing certain jobs?

Yes No

If Yes, describe limitation.

PREVIOUS EXPERIENCE

Please list beginning from most recent. List "None" for all fields in the first job section if you have never been employed.

*Dates Employed:

From To

*Company Name and Location:

*Pay Rate:

*Reason for Termination:

*Job Title and tasks performed:

Dates Employed:

From To

Company Name and Location:

Pay Rate:

Reason for Termination:

Job Title and tasks performed:

Dates Employed:

From To

Company Name and Location:

Pay Rate:

Reason for Termination:

Job Title and tasks performed:

SKILLS CHECKLIST

Please check the skills for which you have at least 6 months on the job experience. All skills checked will be work verified.

Tufting:	Dyehouse:	Drivers:
Creeler Mender Warper Operator Machine Operator Graphics	Beck Operator Dryer Operator Straightening Frame Kuster Operator Shade Matching	CDL Class A CDL Class B Short Haul Haz Mat Tanker

Sample:	Yarn:	Industrial:
Beveler Swatcher Binder Serger Label Cut label	Twister Winder Spinner Superba Operator Extrusion Air Entanglement	Production Assembly Packing Warehouse Stamping Picker/Packer

Shipping & Receiving:	Clerical:	Metal Working:
Forklift Certified Forklift Pole Hyster Squeeze Hyster Buggy/Tug Cherry Picker Bills of Lading Manifests Dispatch Stand up forklift Loading/Unloading Pallet Jack Electric Pallet Jack	Typing WPM Human Resources AP/AR Scheduling CSR Admin. Assistant Sales Bookkeeper Purchasing Telemarketing	Welding Mig Tig Arc Stick Powder Coating Press Operator Grinder Metal Fabricator Read Tape Measure Read Blueprints

Finishing:	General:	Specialized:
Coater Operator Tenor Wing Roll On Sew On Inspector Shearing Machine Wrapper	Housekeeping Construction Clean up Inventory Control Quality Control Quality Assurance	Electrician HVAC Maintenance Mechanic

Computer Experience:	Food Services:	Landscaping:
MS Word MS Excel AS400 PowerPoint	Dishwasher Hostess Cook Server	Landscape plans Weed Eater Mower

Retail:	Others Not Listed:
Cashier CSR Sales

* I hereby declare the information provided by me in this Application for Employment is true, correct and complete to the best of my knowledge. I understand that is employed, any misstatement or omission of fact on this application shall be considered cause for dismissal.

* I authorize you to obtain an investigative consumer report containing information obtained through personal interviews with my neighbors, friends and acquaintances. This report if obtained may include information as to my character, general reputation, personal characteristics and mode of living. I understand I have the right to make a written request within a reasonable period to receive additional detailed information about the nature and scope of any such investigation. I will be charged a $10.00 administration fee for all processing of paperwork & will be deducted out of first paycheck once work has begun.

ALL APPLICANTS ARE HIRED UNDER A 90 DAY PROBATIONARY PERIOD

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