Staffing Services, Inc.

Please complete following form in it's entirety and press submit. A Staffing Services Representative will review your application and will contact you shortly.

GENERAL INFORMATION

SSN::

Last Name::

First Name::

Middle Init::

Address::

City::

State::

Zip:

Phone:

Alt Phone:

How late can we call ?

Applying for which office?

Portland

Bend

Eugene

Roseburg

Available for same day assignments:

Yes No

Transportation:

Car

Bus

Ride

Bike

DL / State: (if applicable)

Days available to work:

Shifts:

day

swing

grave

Hours available:

Emergency contact name:

Emergency contact phone:

EMPLOYMENT HISTORY

Temporary Service Experience

#1)
Name of temporary service:
Dates employed:
Job assignments:
Supervisor:

#2)
Name of temporary service:
Dates employed:
Job assignments:
Supervisor:

#3)
Name of temporary service:
Dates employed:
Job assignments:
Supervisor:

Other Work Experience

Most recent employer:
Most recent employer:
Phone:
Address:
City:
State::
Supervisor:
May we contact:	Yes No
Job title:
Job duties:
Starting pay:
Ending pay:
Dates employed:
Reasons for leaving:

2nd most recent employer:
2nd most recent employer:
Phone:
Address:
City:
State::
Supervisor:
May we contact:	Yes No
Job title:
Job duties:
Starting pay:
Ending pay:
Dates employed:
Reasons for leaving:

3rd most recent employer:
3rd most recent employer:
Phone:
Address:
City:
State::
Supervisor:
May we contact:	Yes No
Job title:
Job duties:
Starting pay:
Ending pay:
Dates employed:
Reasons for leaving:

4th most recent employer:
4th most recent employer:
Phone:
Address:
City:
State::
Supervisor:
May we contact:	Yes No
Job title:
Job duties:
Starting pay:
Ending pay:
Dates employed:
Reasons for leaving:

EDUCATION AND MISCELLANEOUS

High School:
Name of school:
State of school:
Did you graduate?:
Major studies:

College / University:
Name of school:
State of school:
Did you graduate?:
Major studies:

Vocational / Technical:
Name of school:
State of school:
Did you graduate?:
Major studies:

Have you applied with Staffing Services before? No Yes

If so , when:

If yes, did we place you on an assignment? No Yes

If so, where:

Have you been terminated due to misconduct? No Yes

If yes, please explain:

Please list other names and/or Social Security #'s you have used:

AREAS OF EXPERIENCE

Accounting

Auditor
Accounts Payable
.....Coding Invoices
.....Purchase Discounts
Accounts Receivable
.....Aging Schedules
.....Credit Memo
.....Late Charges
Bookkeeping
.....Clerk
.....Full Cycle
Controller
General Accounting
.....COGS
.....Depreciation
.....Financial Statements
.....Reconcilations
Payroll
.....Employer Taxes
.....Payment Cycles
.....Payroll Tax Calc
.....Quarterly Tax Filing
.....Tax Deposits
.....Tax Withholding
.....Ten Key
.....By Touch
.....By Sight

Office

Administrative Asst.
Call Center
Customer Service
Data Entry
.....Alpha
.....Numeric
File Clerk
Help Desk
Internet / Email
Inventory
Legal Secretary
Mail Room
Messenger
Office Manager
Programs
.....Word
.....Excel
.....Other
.....Other2
Reception
.....# of lines
.....# of ext
Sales
Secretary
Telecommunications
Telemarketing
Typing
WPM	WPM =

Light Industrial

Assembly
Bindery
Blueprints
Cabinetry
Delivery Drivers
Electronics Assembly
Fiberglass
General Labor
Inspection
Inventory
Janitorial / Hskpng
Manufacturing
Packaging
Printing
Production
Quality Control
Screen Printing
Shipping / Receiving
Soldering
Warehouse
Welding
.....Arc (stick)
.....Arc (line/wire)
.....Gas
.....MIG (line)
.....TIG (alum/tita)
Wiring Installation

Construction

Carpentry
.....Finish
.....Rough
.....General Labor
Concrete
.....Finish
.....General Labor
General Labor
Landscaping
.....Experienced
.....General Labor
Masonry
Painting
.....Residential
.....Commercial
.....Industrial
Steel / Metal work

Machinery

CNC Operator
Drill Press
Forklift
Grinder
Pneumatic Tools
Press Brake
Punch Press
Sheet Operator

Related Skills

Languages you are fluent:

Certifications, licenses, other experience: