Value * Integrity
Professional* Quality


 
 
 
Application for at-will employment

WE ARE AN AT-WILL, EQUAL OPPORTUNITY EMPLOYER.
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, marital or veteran status, disability, or any other legally protected status.

This application will remain active for 180 days.
Position Applied for:
How Did You Learn About Us?:
Advertisement:
Friend:
Employment Agency:
Relative:
Web:
Other:
Last Name:
First Name:
Middle Name:
Address:
City:
State: Zip Code:
Home Phone: Cell Phone:
On what date would you be available to work?
Are you available to work:
Check all that apply.
Full Time:
Part Time:
Shift Work:
Temporary:
 
Yes No    
If you are under 18 years of age, can you provide required proof of your eligibility to work?
Have you ever filed an application with us before? If Yes, give date:
Have you ever been employed with us before? If Yes, give date:
Are you currently employed?
May we contact your present employer?
Are you currently on “layoff” status and subject to recall?
Can you travel if a job requires it?
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
(Proof of citizenship or immigration status will be required upon employment.)
Have you been convicted of a crime within the last 7 years?
(Conviction will not necessarily disqualify an applicant from employment.)
If Yes, please explain:
 

 

 


Education
  Name and Address of School Course of Study Years Completed Level of Completion
High School
Name:
Address:
Undergraduate College
Name:
Address:
Graduate Professional
Name:
Address:
Other (Specify)
Name:
Address:

Indicate any foreign languages you speak, read, and/or write.
  Fluent Good Fair
Speak
Read
Write
 
Describe any specialized training, apprenticeship, skills and extra-curricular activities.
Describe any job-related training received in the United States military.

Employment Experience
Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations that indicate race, color, religion, gender, national origin, disabilities, or other protected status.
Employer:
Dates Employed:
From:  To:
Work Performed:
Job Title:
Hourly Rate/Salary:
Starting:   Final:
Employer Phone:
Employer Address:
Reason for Leaving:
Employer:
Dates Employed:
From:  To:
Work Performed:
Job Title:
Hourly Rate/Salary:
Starting:   Final:
Employer Phone:
Employer Address:
Reason for Leaving:
Employer:
Dates Employed:
From:  To:
Work Performed:
Job Title:
Hourly Rate/Salary:
Starting:   Final:
Employer Phone:
Employer Address:
Reason for Leaving:
Employer:
Dates Employed:
From:  To:
Work Performed:
Job Title:
Hourly Rate/Salary:
Starting:   Final:
Employer Phone:
Employer Address:
Reason for Leaving:

Additional Information.
 List professional, trade, business, or civic activities and offices held.
You may exclude memberships that would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status:
 
Other Qualifications
Summarize special job-related skills and qualifications acquired from employment or other experience:
 
State any additional information you feel may be helpful to us in considering your application.

References
Name: Phone:
Address:
Name: Phone:
Address:
Name: Phone:
Address:


 
 
New Page 1 Preferred Companies, Inc., 109B Pilgrim Rd, Greenville, SC 29607   Phone# 864-329-1998
   
 
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