APPLY

Legal Division

Secretarial

Information Technology Placements

Proven Temporary Placements

Information Technology Placements : Application

APPLICATION FOR TEMPORARY AND/OR PERMANENT EMPLOYMENT

This is an application which we will use to secure an employment position for you. Accordingly, it is important that you complete all sections as fully as possible. Thank you for working with us. We look forward to a successful relationship.

NOTE: All fields and sections marked with * are required.

What type of position are you interested in?

Where would you like your application sent?

Name

*Last *First MI

*SSN Maiden Name

Address

*Street *City *State

*Zip

Contact

*Home *Work

Cell/Pager E-Mail

Referred By Emergency Contact

NOTE: A record of conviction does not necessarily disqualify you from employment consideration.

Have you ever been convicted of a crime other than a misdemeanor or summary defense? YesNo

If yes, please explain:

Consistent with federal laws, applicants who are offered employment will be required to produce documentation confirming their identity and United States employment eligibility.

Are you a United States citizen or legally authorized to work in the U.S.?
YesNo

*Employment Record

NOTE: Your application will not be considered unless every question in this section is answered. Since we will make every effort to contact previous employers, the correct telephone numbers of past employers is critical. Also please explain any gaps in your employment history.

Most Recent Employer

Company City State

Telephone Fax

Dates Employed

From To

Job Title Supervisor

Description of work performed:

Salary

Start End

Are you currently working for this employer? YesNo
If yes, may we contact? YesNo

If not, what was your reason for leaving?

Next Most Recent Employer

Company City State

Telephone Fax

Dates Employed

From To

Job Title Supervisor

Description of work performed:

Salary

Start End

What was your reason for leaving?

Next Most Recent Employer

Company City State

Telephone Fax

Dates Employed

From To

Job Title Supervisor

Description of work performed:

Salary

Start End

What was your reason for leaving?

*Educational Background

College/University Attended

City State GPA

Degree Graduate?YesNo Year

Trade School Attended

City State

Diploma Graduate?YesNo Year

Vocational School Attended

City State

Diploma Graduate?YesNo Year

*References

NOTE: These are individuals who are supervisors qualified to give an opinion of your ability and experience. Do not include relatives.

First Reference

Name

Relationship Years Known

Address City State

Zip

Phone E-Mail

Second Reference

Name

Relationship Years Known

Address City State

Zip

Phone E-Mail

Third Reference

Name

Relationship Years Known

Address City State

Zip

Phone E-Mail

Skills

Top Technical Skills

Skill Years Experience

General Conditions
By submitting this electronic application, you are confirming that the information provided above is true and you authorize us to verify such information, check references and conduct a background check, which includes a criminal check and Social Security verification, and agree to release Legal Placements, Inc. and its agents or employees from any and all liability from any and all claims in connection with any application or the investigation thereof. Legal Placements, Inc. considers applicants for all positions on the basis of qualifications without regard to race, color, religion, sex, national origin, citizenship, ancestry, age, marital or veteran status, physical or mental handicap or disability, or any other legally protected attribute.