Staff Application – People First Industries

Applicant Name (Last, First) *
Present Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
How Long At Present Address? *
Phone *
If Under 18, Please List Age
Position Applied For *
Desired Salary *
What Days Are You Available To Work? *
MondayTuesdayWednesdayThursdayFridaySaturdaySunday
How Many Hours Can You Work Weekly? *
Can You Work Nights? *
Employment Desired *
When Are You Avialable To Start? *
Education History Please list name of school, location, number of years completed, and any degrees obtained.
*
Have You Ever Been Convicted Of A Crime? *
If yes, please explain the number of conviction(s), nature of offense(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Have You Ever Been In The Armed Forces? *
Are You Now A Member Of The National Guard? *
If Yes, please list specialty, date entered, and date discharged if applicable.

Instructions Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give the firm name. For each employer, please list Name, Address, Phone Number, Supervisor Name, Employment Dates, Start and End Salary, Job Title and Reason For Leaving. Please also list duties performed, skills used or learned, and any advancements or promotions.
Employer #1
Employer #2
Employer #3
Do You Have A Driver's License? *
What Is Your Means of Transpportation to Work? *
Have You Had Any Accidents Within The Last Three Years? *
If Yes, How Many?
Have You Had Any Moving Violations In The Last Three Years? *
If Yes, How Many?

Please List Two References Other Than Relatives or Previous Employers
Reference #1
Name of Reference First Reference *
Position *
Company *
Address of Reference *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone Number of Reference *
Reference #2
Name of Second Reference *
Position *
Company *
Address of Reference *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone Number of Reference *
Additional Information
An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use this space to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.