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First name
Middle Name
Last Name
Email
Mailing Street Address
Mailing Street Address Line 2
Mailing City
Mailing Region/State/Province
Mailing Zip code
Physical Street Address
Physical Street Address Line 2
Physical City
Physical Region/State/Province
Physical Zip code
Physical Address Same As Mailing Address
Phone
Alternate Phone
SOCIAL SECURITY NUMBER
Available Start Date
Desired Salary:
Position Applied For
Are You A Citizen Of The United States?
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How Did You Hear About SS Staffing
Have You Ever Worked for SS Staffing?
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If you have worked for SS Staffing please remind us when
Have You Ever Been Convicted Of A Felony?
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If You Have Been Convicted Of A Felony Please Explain
Select All That Apply
No Diploma
In High School
High School Or Equivalent
Technical Or Occupational Cetificate
Associate Degree
Some College Coursework Completed
Bachelor’s Degree
Master’s Degree
Doctorate
Professional
I’m Currently Completing My Degree
Other Coursework
Previous Employer
Address
Job Title
Phone
Supervisor
Starting Salary
Ending Salary
Responsibilites
Dates At This Employer
Reason For Leaving
May We Contact Your Previous Supervisor For A Reference
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Previous Employer
Address
Job Title
Phone
Supervisor
Starting Salary
Ending Salary
Responsibilites
Dates At This Employer
Reason For Leaving
May We Contact Your Previous Supervisor For A Reference
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Military Service
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Dates Of Service
Rank At Discharge
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If Other Than Honorable, Explain
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts is cause for termination. I agree to comply with SS Staffing substance abuse program, including drug testing that may be required. I understand that SS Staffing will thoroughly investigate my work and personal history. I authorize such an investigation and release from liability any person’s giving or receiving such information. If employed, I agree to conform to the policies and procedures of SS Staffing Inc and agree that my employment can be terminated at any time with or without cause, at the option of myself or SS Staffing, Inc. We are an “At will” employer.
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