Employment Applications - Jobs Near Me at ABStaffing

1Application Info

2Release

3Disclosure

This form has been designed especially to help you. Please answer all questions fully: a resume does not preclude completing the application. Completion of this form places you under no obligation. It will permit us to review your record and give it careful consideration. The more we know about your background and ambitions, the better we can determine if we can put your abilities to the most productive use for our mutual benefit. All information supplied by you will be treated as personal and kept confidential.
Identifying Data
Date*
MM slash DD slash YYYY
Name*
Home/Cell Phone*
Business Phone
Address*
Street Address Address Line 2 City State ZIP Code
How Did You Learn About This Position?*
- Ad
- Referred By
- Other (agency, etc.)
(please select one of the following:)
Ad (please specify job website)*
Referred By (please provide name)*
Other (agency, etc.: please specify)*
For What Position Are You Applying?*
Your Current Salary Requirement:*
Why Do You Feel That You Are Qualified For This Job?*
Educational Data
High School Education
Name and Location Coursework Did You Graduate?
College Education
Name and Location Coursework Did You Graduate?
Graduate School
Name and Location Coursework Did You Graduate?
Other Education
Name and Location Coursework Did You Graduate?
A RESUME DOES NOT PRECLUDE COMPLETING THE APPLICATION.
Employment Data
Omit military service. Start with your present or most recent position first, then list the position prior to that, and so forth. Please fill out completely. Record dates as MO/YR. Attach additional sheets if necessary.
Name of Company*
Location*
Type of Business*
Position*
Employment Start Date*
Employment End Date*
Description of Duties*
Immediate Supervisor*
Name Title Phone
Reason for Leaving*
Name of Company
Location
Type of Business
Position
Employment Start Date
Employment End Date
Description of Duties
Immediate Supervisor
Name Title Phone
Reason for Leaving
Name of Company
Location
Type of Business
Position
Employment Start Date
Employment End Date
Description of Duties
Immediate Supervisor
Name Title Phone
Reason for Leaving
Which of Your Jobs Did You Like Most?*
Why?*
Which of Your Jobs Did You Like Least?*
Why?*
References
Please provide three (3) direct report employment references that may be contacted at this time.
Direct Employment Reference*
Name Company/Title Phone
Direct Employment Reference*
Name Company/Title Phone
Direct Employment Reference*
Name Company/Title Phone
Are You Legally Authorized To Work In The U.S.?*
- Yes
- No
Unemployment Data
Explain and give details of any period of unemployment lasting longer than 30 days:
Emergency Contact*
Name Address Phone
In case of Emergency, Notify

Disclosure / Authorization Statement
By this document, AB Staffing Solutions, LLC discloses that a consumer report may be obtained for employment purposes as part of the pre-employment background investigation and at any time during my employment. Consumer reports include criminal background investigation, FACI (Fraud and Abuse Control Information System), OIG exclusion list (Office of Inspector General – to ensure that Applicant has not been excluded from the Medical/Medicaid list), Sexual Offender Database and Social Security Trace.

This shall authorize the procurement of a consumer report by AB Staffing Solutions, LLC as part of the pre-employment background investigation. If hired, this authorization shall remain on file and shall serve as an ongoing authorization for AB Staffing Solutions, LLC to procure consumer reports at any time during my employment period.

In connection with this request, I authorize all corporations, companies, former employers, supervisors, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts, motor vehicle bureaus, military services and persons to release information they may have about me to the person or company with which this form has been filed, or their agent, Sterling InfoSystems, Inc. and release all parties involved from any liability and responsibility for doing so. This authorization, in original or copy form, shall be valid for this and any future reports or updates that may be requested.

I understand that I have the right to request additional disclosure as to the nature and scope of the investigation, upon written request, within a reasonable period of time. I authorize the National Personnel Records Center, St. Louis MO or other custodian of my military records to release to Sterling InfoSystems, Inc. information or photocopies of my military personnel and related medical records, or only the following information/records:
Service #
Branch of Service
Service Start Date
Service End Date
Name
Date
MM slash DD slash YYYY
Signature
Birth Name
Date of Birth
MM slash DD slash YYYY
Driver ID #
State

Insurance Supplemental Questionnaire
Office
Applicant's Name
Phone
Address
Street Address Address Line 2 City State ZIP Code
All employees may be subject to being Bonded. To obtain coverage for you, AB Staffing Solutions, LLC must submit certain information to our Insurance Representative. Explain in detail the circumstances surrounding the Criminal Conviction set forth on your Confidential Application for Employment as follows:
Date of Conviction
MM slash DD slash YYYY
County & State where you were convicted
Specify the crime for which you were convicted
If theft, specify amount
Was this a Felony conviction?
- Yes
- No
Specify the sentence you received
Are you currently on probation?
- Yes
- No
Provide name and telephone number of your Probation Officer*
Provide any additional information you feel might help our Insurance Representative in securing coverage for you
Signature
Date
MM slash DD slash YYYY

Identifying Data

Educational Data

Employment Data

References

Unemployment Data

Applicant Certification Authorization For Release

Disclosure / Authorization Statement

Insurance Supplemental Questionnaire