Josephine's Professional Staffing, Inc.

EMPLOYMENT APPLICATION

Thank you for taking the time to complete our online employment application. Please fill out the application below as completely as possible. This application will take approximately 15 minutes to complete.


Personal Information
* Denotes Required Fields

Are you at least 18 years of age and do you have the legal right to work in the United States?		  
Yes  No
First Name *  
Middle Name  
Last Name *  
Nickname / Preferred Name  
Street Address / Apartment #     
City  
State / ZIP Code    
Home Phone *   - Area code and phone number
Other Phone   - Area code and phone number
Email Address  


Resume: If you have a plain-text resume, paste it into the box below.

Availability
Are you willing to work temporary?   Yes  No
Are you looking for a full-time career position?   Yes  No
Are you looking for contract positions?   Yes  No
When are you available to start?  
What weekday hours are you available?  
What weekend hours are you available?  
How many hours are you willing to work in a week?  
Are you willing to work overtime?   Yes  No
What is the minimum pay you desire?   Hourly rate or annual salary
How much notice will you need if a position is offered to you?  
How many miles are you willing to travel to a position?  
 
This question determines who is responsible for reviewing this application in eApprovals?  

Education
Enter most recent - Do not enter start and end date if the most recent is high school
Name of School  
Type of school  
Street Address  
City  
State / ZIP Code     
Start Date (Month / Year)  
End Date (Month / Year)  
Degree  
Major Study Area  
Other Studies  
 

Recent Employment
List most recent first
Company Name  
Street Address  
City  
State / ZIP Code    
Supervisor Name  
Job Title  
Job Duties  
Start Date (Month / Year)  
End Date (Month / Year)  
May we contact this employer for a reference check?   Yes  No
Company Name  
Street Address  
City  
State / ZIP Code     
Supervisor Name  
Job Title  
Job Duties  
Start Date (Month / Year)  
End Date (Month / Year)  
May we contact this employer for a reference check?   Yes  No
Company Name  
Street Address  
City  
State / ZIP Code     
Supervisor Name  
Job Title  
Job Duties  
Start Date (Month / Year)  
End Date (Month / Year)  
May we contact this employer for a reference check?   Yes  No

Confirmation

I certify that the statements I have made are true and correct and without material omission. I understand that making false statements or omitting pertinent facts is sufficient cause for rejection or dismissal from employment. I authorize obtaining information from any person(s), employers, educational institutions, licensing authorities, and/or law enforcement agencies concerning my background, work habits, skill or conduct on the job, with the exception of past employer(s) I have indicated that are not to be contacted. I hereby release such person or entities from all liability for damages for issuing such information.

When I am employed I agree that if at any time I make claims for personal injuries, I will submit myself, upon written request, to examination by a physician or physicians of employer’s selection, at employer’s expense, as often as may be requested.

I also agree that if I am employed, now or at any time in the future, my employment may be terminated at any time without liability to me for wages or salary except for such wages or salary which I earned prior to the date of my termination. I understand the term of my employment shall be limited to the duration of any assignment that I accept.

I am aware that Public Law 91-508, known as the Fair Credit Reporting Act, requires the employer to inform me that a routine inquiry may be made that will provide applicable information concerning my character, my general reputation, my personal characteristics and my credit history. Upon written request, I will provide additional information as to the nature and scope of the inquiry or any report which is produced.

I understand that I am applying for temporary or contract assignments. The completion of the this application process shall constitute a conditional offer of employment subject to my availability and the availability of customer assignments calling for the skill and qualifications that I possess, and I agree to consider acceptance of such assignments.

Please take a moment to review your application.  Indicate that you have read the above statement by entering your initials in the box below.  To complete this application, click on the Submit Application button.
Initials:  

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.