Employment Application

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Alternative Services for Individuals LLC.

ALTERNATIVE SERVICES FOR INDIVIDUALS APPLICATION

Position Applying For:

Last Name:

First Name:

Middle Name:

Date of Birth (mm/dd/yy)

MAILING ADDRESS: House / Apt No.

Street

City

Postal Code

PERMANENT ADDRESS (If Different from Above Address)

TELEPHONE: Home:

Email

Are you legally entitled to work in USA

YesNo

As an adult, have you ever been convicted of an offense other than a traffic violation?

YesNo

Are you able to work any shift ?

YesNo

Do you have any relatives working with this agency and/or did a current employee refer you to this agency?

YesNo

If yes, please enter full name(s):

EDUCATION AND TRAINING High School /GED Name & location of institution

Number of years completed

Field of Study

Grade/Diploma/Degree and year completed

Commercial, Trade or Technical Training Name & location of institution

Number of years completed

Field of Study

Grade/Diploma/Degree and year completed

Undergraduate College/University Name & location of institution

Number of years completed

Field of Study

Grade/Diploma/Degree and year completed

Graduate/ Professional Name & location of institution

Number of years completed

Field of Study

Grade/Diploma/Degree and year completed

Other Continuing Education Name & location of institution

Number of years completed

Field of Study

Grade/Diploma/Degree and year compleated

Professional Qualifications/ Memberships/Licenses if applicable:

SECRETARIAL/CLERICAL SKILLS:

Word processing SoftwareSpreadsheet SoftwareDatabase SoftwareKeyboardingDictaphoneData EntryGraphicsSpecial Terminolgy

If the keyboarding box was checked above, please indicate the nwpm

Other(Specify)

COMPUTER SKILLS:

IBMMacVAX / VMS

Please specify computer systems you have worked with, courses you have taken and your working knowledge of computer software:

TECHNICAL SKILLS:

TRADES/MAINTENCE SKILLS:

LANGUAGE SKILLS: Spoken and Written

If you are applying for a position requiring a driver's license, please complete the following: Do you have a valid driver's license?

YesNo

Previous Employment (begin with most recent) Name of Employer:

Address:

Last Position Held:

Phone:

Name of Supervisor:

TextReason for Leaving:

Employment From:

To:

Final Salary:

Duties:

Name of Employer

Address:

Last Position Held:

Phone:

Name of Supervisor:

Reason for Leaving:

Period Employed

Final Salary:

Duties:

Name of Employer:

Address:

Last Position Held:

Phone:

Name of Supervisor:

Reason for Leaving:

Period Employed:

Final Salary:

Duties:

List three pers, other than relatives or personal friends, who can judge your work ability. Name, Company, Position, and Telephone #

May we contact your present employer for a reference?

YesNo

Previous employer?

YesNo

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Home
About Us
Employment Application
Contact Us
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Gallery
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Home
About Us
Employment Application
Contact Us
Main Office Residence Gallery
My Blog
Adult Day Training Program
Gallery
Service Reviews

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