PERSONAL INFORMATIONLegal First Name(Required)Legal Last Name(Required)Middle InitialFormer Name(s)If ApplicableSocial Security Number(Required)Street Address(Required)City(Required)State(Required)Zip(Required)Home Telephone(Required)Alternate TelephoneHave you ever worked for Innovative Staff Solutions or Spherion?(Required) Yes NoIf Yes, please provide details.Include location and dates of employment.Have you ever been convicted of a felony, misdemeanor or any other offense other than a minor traffic violation?(Required) Yes NoIf Yes, please provide details.Convictions will not necessarily bar employment.How did you learn about our employment opportunities?(Required) Job Fair Website Employee Referral Building Sign OtherEDUCATIONHigh School Name & Location# Years AttendedCourse of StudyDid you graduate? Yes NoDegree, Diploma, GED or CertificateCollege Name & Location# Years AttendedCourse of StudyDid you graduate? Yes NoDegree, Diploma, GED or CertificateOther (Vocational, Technical, Military Training, etc.) Name and Location# Years AttendedCourse of StudyDid you graduate? Yes NoDegree, Diploma, GED or CertificateEMPLOYMENT HISTORYMost recent to least recent.Company NameCompany AddressPosition/TitleDates of employment (From MO/YR to MO/YR)Manager's Name & TitleTelephone:May we contact? Yes NoIf "No," please explain.Starting Salary/WagePerHourYearEnding Salary/WagePerHourYearResponsibilitiesCompany NameCompany AddressPosition/TitleDates of employment (From MO/YR to MO/YR)Manager's Name & TitleTelephone:May we contact? Yes NoIf "No," please explain.Starting Salary/WagePerHourYearEnding Salary/WagePerHourYearResponsibilitiesCompany NameCompany AddressPosition/TitleDates of employment (From MO/YR to MO/YR)Manager's Name & TitleTelephone:May we contact? Yes NoIf "No," please explain.Starting Salary/WagePerHourYearEnding Salary/WagePerHourYearResponsibilitiesREFERENCESPlease provide three references. Include two previous supervisors and one other.Reference Name(Required)Company Name(Required)Title(Required)Relationship(Required)Years Known(Required)Email Address(Required)Telephone(Required)Reference Name(Required)Company Name(Required)Title(Required)Relationship(Required)Years Known(Required)Email Address(Required)Telephone(Required)Reference Name(Required)Company Name(Required)Title(Required)Relationship(Required)Years Known(Required)Email Address(Required)Telephone(Required)By checking the below, I confirm and agree to the following:(Required) I confirm and agree.The information I have provided is true and correct to the best of my knowledge. I authorize you to confirm any of the information provided, obtain employment references and personal history and obtain a consumer report, which may include a criminal background, DMV and/or credit check information. Other Federal, State or local governmental agencies, former employers and former schools, may also be contacted. I also authorize you to disclose any pertinent information concerning me to others. Further, I release all parties and persons from any liability that may result from furnishing such information to you, as well as, from the use or disclosure of such information by you. Any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer of employment or my dismissal from employment if I am hired. I agree that my employment relationship with Innovative Staff Solutions (“the Company”), can be terminated at will either by me or the Company, with or without cause and without notice, at any time.
