Employment Application

After you submit your application you will be redirected to a confirmation page. If you have not been redirected to the confirmation page your application has not been submitted.


Personal Information
Job Position Applying For:
First and Last Name:
Home Address:
City:
State:
Zip:
Phone: ()
Email:
How old are you?


Are you legally eligible for employment in the United States?
Availability
  MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
FROM
TO
Available Start Date:
Wage desired:
Number of hours desired per week:
Education
  School Name Major Course of Study Last Year Completed Did you graduate?
High School
College
Other
Have you served in the US Armed Forces? If so, what branch?
List any additional training or skills that may be relevant to the position that you are applying for:
Other Information
Have you ever been employed by One Stop?
If yes, previous dates of employment:
Can you, with or without a reasonable accommodation, perform the essential functions of the job for which you applied?
Please explain:
Have you ever been convicted of a felony or have felony charges pending?
If yes, please explain:
How many pounds can you lift on a continuous basis?
Would you be willing to take a drug test?
Employment History
Current or more recent employer
Company Name:
Address:
Phone: ()
Start Date:
End Date:
Start Wage:
End Wage:
Hours Worked Per Week:
Job Title:
Job Duties:
Reason for Leaving:
Next most recent employer
Company Name:
Address:
Phone: ()
Start Date:
End Date:
Start Wage:
End Wage:
Hours Worked Per Week:
Job Title:
Job Duties:
Reason for Leaving:
Next most recent employer
Company Name:
Address:
Phone: ()
Start Date:
End Date:
Start Wage:
End Wage:
Hours Worked Per Week:
Job Title:
Job Duties:
Reason for Leaving:
References
Reference 1
Name:
Company:
Phone: ()
Position:
Reference 2
Name:
Company:
Phone: ()
Position:
Reference 3
Name:
Company:
Phone: ()
Position:
Referral
How did you hear about this job?