Professional Staffing Services, Inc.

APPLICATION FOR EMPLOYMENT
PRE-EMPLOYMENT QUESTIONNAIRE
EQUAL OPPORTUNITY EMPLOYER

PERSONAL INFORMATION

EMPLOYMENT DESIRED

ARE YOU EMPLOYED? —Please choose an option—YesNo
IF SO, CAN WE INQUIRE OF YOUR PRESENT EMPLOYER?
—Please choose an option—YesNo
CHECK ALL THAT APPLY:
—Please choose an option—Second ShiftThird ShiftWeekends

Have you ever been convicted of a felony or misdemeanor?
—Please choose an option—YesNo
If yes, explain:

EDUCATION HISTORY

HIGH SCHOOL


GRADUATE? —Please choose an option—YesNo
SUBJECTS STUDIED
Enter Related Subjects

COLLEGE


GRADUATE? —Please choose an option—YesNo
SUBJECTS STUDIED
Enter Related Subjects

TRADE, BUSINESS OR CORRESPONDENCE SCHOOL


GRADUATE? —Please choose an option—YesNo
SUBJECTS STUDIED
Enter Related Subjects

U.S. MILITARY OR NAVAL SERVICE:
—Please choose an option—YesNo

FORMER EMPLOYER (LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH LAST ONE FIRST)

REFERENCES: PLEASE LIST THREE PREVIOUS BUSINESS EMPLOYER REFERENCES BELOW

[recaptcha recaptcha-765]