Personal
First Name, Middle Initial, Last Name

Current Address, City, State & Zip   

Phone Number with Area Code         

Previous Address, City, State & Zip  

Email Address

Driver's License Number      (State Florida Other State)


Position you are applying for:

Your Profile
Have you ever been convicted of a felony? No   Yes, Explanation:

Availability: Full Time     Part Time         When can you start?:

Highest Level of School Completed

List any health conditions or concerns

Current or Most Recent Job of Employment   (May we contact? Yes No)

Titles & Duties

Contact name & title

Contact phone number

Length of employment (be specific from when to when)

Reason for leaving

Previous Job of Employment   (May we contact? Yes No)

Previous Titles & Duties

Previous Contact name & title

Previous Contact phone number

Previous Length of employment (be specific from when to when)

Previous Reason for leaving


Do you have transportation? Yes   No   
Vehicle Description: (required; if none, enter none)
 

Can you lift 50 pounds if needed? Yes   No

List any special skills

List any certifications

In the space below, please list any notes or explanations if needed

Pre-employment Screening
 What experience do you have that will be helpful for this job?   
 
 Of any job you've had, which did you like the least & why?         
 
 How do you rate your ability to prioritize work, manage time and set goals?
 
 Of any job you've had, which did you like the best & why?
 
 Describe a typical day at your current or last job
 
 What do you consider to be your (job related) strong points?
 
 What do you consider to be your (job related) weak points?
 
 Do you have any friends or family or know anyone who has ever worked with us?
 
 If offered a job, would you submit to a medical exam or drug test?
 
 What is your long term career objective?
 
  Have you ever been terminated from a job? If yes, please describe.
 
 What are your salary and benefits expectations from this new job?
 
 What final thoughts or comments would you like to submit with this application?
 
How did you hear about this job listing?
 

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IS FOUND TO BE INCORRECT AT ANY TIME AFTER EMPLOYMENT, YOU MAY BE TERMINATED
WITHOUT NOTICE OR COMPENSATION. YOU AGREE TO SUBMIT TO DRUG SCREENING IF REQUIRED.
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USING ANY OR ALL INFORMATION GIVEN ON THIS FORM. IF HIRED FOR EMPLOYMENT, YOU WILL BE
EMPLOYED UNDER A 90 DAY PROBATIONARY PERIOD, DURING WHICH YOU MAY BE LET GO FOR
ANY REASON AT OUR DISCRETION. PLEASE ALLOW 7 BUSINESS DAYS TO PASS BEFORE CALLING
OR RESUBMITTING AN APPLICATION FOR EMPLOYMENT. FOR BEST RESULTS, PLEASE FAX US A
RESUME (IN ADDITION TO THIS APPLICATION) TO (904) 899-4654 ATTENTION: JOB LISTINGS.