Guidance Staffing Employment Application
Contact Information
Last Name
First Name
Middle Initial
Address
City
State
Zip
Home Phone
Business Phone
Cellular Phone
Email
How did you learn of our service?
Website
Newspaper
Referred by
Other
Eligible to work in the US?
Yes
No
Employment History
(must be completed even if you have submitted a resume)
Dates(most recent)
Company/Facility Name
Name & Title of your manager
Salary
From:
Base:
To:
Address
Type of Business
Bonus
Your Title/Responsibility/# of Direct Reports
Reason for leaving
Commission
Dates(most recent)
Company/Facility Name
Name & Title of your manager
Salary
From:
Base:
To:
Address
Type of Business
Bonus
Your Title/Responsibility/# of Direct Reports
Reason for leaving
Commission
Dates(most recent)
Company/Facility Name
Name & Title of your manager
Salary
From:
Base:
To:
Address
Type of Business
Bonus
Your Title/Responsibility/# of Direct Reports
Reason for leaving
Commission
Dates(most recent)
Company/Facility Name
Name & Title of your manager
Salary
From:
Base:
To:
Address
Type of Business
Bonus
Your Title/Responsibility/# of Direct Reports
Reason for leaving
Commission
Education
Name of School
Years Attended
Year of Graduation
Degree and Major
Grad School/Other
College
High School
Diploma
GED
Have you ever been convicted of a crime other than a traffic violation?
Yes
No
If yes, please explain
Do you have use of a car?
Yes
No
Willing to relocate
Yes
No
If yes, where?
Position Desired
Temporary
Permanent
Consultant
Minimum salary considered
Location preferred
Qualifications and Skills
General
PC Literate
Yes
No
Proficient
Yes
No
Keyboard Speed
WPM
Software Knowledge
Medical
Last Physical
Do you have a uniform?
Yes
No
Military Certified
Yes
No
Certified
Yes
No
Describe
Expiration
Other
Foreign languages, if any, indicate knowledge or fluency
Location
Which of our offices would you like to send this application to?
New York City
Seattle Metro Area