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Application for Employment

This company is an equal opportunity employer and will not unlawfully discriminate or retaliate, or tolerate unlawful discrimination or retaliation, against any applicant or employee. If you need assistance or a special accommodation to provide any of the following information to participate in the application process, please let us know and we will be happy to help you.

Date: Wednesday, June 19, 2013

Job/Location Information

Select the location where you would like this application to be sent.
Select multiple by holding down CTRL and clicking.

Job Selected: General Application

Location^*:

Personal Information

Are you at least 18 years old? ^*:
Yes No

Do you have a legal right to work in the U.S. without sponsorship? ^*:
Yes No

Have you ever been convicted of a felony, misdemeanor or other offense other than any sealed, expunged or statutorily eradicated convictions or minor traffic violations?^*:
Yes No

NOTE: Convictions will not necessarily bar employment. This information will only be used for job-related purposes consistent with applicable law and is only relevant in determining whether the conviction is related to the job for which you are applying. Factors to be considered vary depending on applicable law; however, they regularly include but are not limited to: age at the time of the offense(s), recentness of the offense(s), seriousness of the offense(s), nature of the violation(s), its relation, if any, to the job you are seeking, and rehabilitation will be taken into account. You are not obligated to disclose convictions that have been sealed, expunged, erased, annulled, impounded, dismissed under a First Offenders Law, pardoned by the Governor, or statutorily eradicated.

Contact Information

Last Name^*:	First Name^*:		Middle Name:
Former Name(s):
Preferred First Name:	Social Security Number:
Home Address
Address:
City:	State:	Zip:	Country:
If the Home Address provided is not your mailing address, please provide below:
Mailing Address:
City:	State:	Zip:	Country:
Phone Numbers
Primary^*:	Work:	Cell:
Pager:	Other:
Email Address
Email:
Emergency Contact Information
Name:
Phone:	Email:

General Information

How did you hear of Spherion?:

Availability

What type of position(s) interest you?:

Accounting	Clerical	Light Industrial
Office Services	Professional	Technical Engineering

First Date Available:

Last Date Available:

What type of position(s) interest you?:

Part-Time	Full-Time	Either
Temp	Temp to Hire

Are you willing to work overtime?:

Yes

Desired Work Hours per Week:

How much notice do you require prior to accepting an assignment or an interview? :
Same Day
One Day
Other

Desired Compensation

Minimum Acceptable Rate $:

Hourly Anually

Education

High School
High School:
City:	State:	Country:
Did you graduate?: Yes No
College / University 1
College/University Name:
City:	State:	Country:
Degree:		Did you graduate?: Yes No
Major:
Email:		Web Address:
College / University 2
College/University Name:
City:	State:	Country:
Degree:		Did you graduate?: Yes No
Major:
Email:		Web Address:

Recent EmploymentPlease start with your most recent employment and list previous ones thereafter.

Most Recent Employment
Employer:	Start Date:	End Date:
City:	State:	Zip:	Country:

Supervisor Name:		Supervisor Job Title:
Supervisor Email:		Supervisor Phone:
Company Website URL:		Reason for leaving:
Working Job Title:		Status: Full-Time Part-Time	May We Contact? : Yes No
Starting Pay $:	Ending Pay $:	Would you return to the employer: Yes No
Duties:

Second-Most Recent Employment
Employer:	Start Date:	End Date:
City:	State:	Zip:	Country:

Supervisor Name:		Supervisor Job Title:
Supervisor Email:		Supervisor Phone:
Company Website URL:		Reason for leaving:
Working Job Title:		Status: Full-Time Part-Time	May We Contact? : Yes No
Starting Pay $:	Ending Pay $:	Would you return to the employer: Yes No
Duties:

Third-Most Recent Employment
Employer:	Start Date:	End Date:
City:	State:	Zip:	Country:

Supervisor Name:		Supervisor Job Title:
Supervisor Email:		Supervisor Phone:
Company Website URL:		Reason for leaving:
Working Job Title:		Status: Full-Time Part-Time	May We Contact? : Yes No
Starting Pay $:	Ending Pay $:	Would you return to the employer: Yes No
Duties:

Skill SetsBased on your education and industry knowledge, please indicate your skills, experience and expertise below. Check all that apply.

Clerical / Customer Service

Accounting	Payroll	Office Manager
Payables	Customer Service Rep	Shipping/Receiving Clerk
Receivables	Call Center Rep	Shipping/Receiving Materials
General Ledger

Non Clerical

Admitting Clerk	Medical Billing	Mental Health Tech
Discharge Coordinator	Medical Secretary	Patient Account Rep
Medical Assistant	Medical Transcription

Skilled

Welding	Draftsman	PLC Tech
Forklift Operator	Graphic Design	Pneumatics
Industrial Machine Maintenance	Industrial Electrician	Robotic Tech
Tool & Die	IT Tech	AutoCAD
Auto Body	Mechanical	CNC

Production

Assembly	Inventory	Maintenance/Custodial
Shipping	Packaging	Distribution
Quality Control/Inspection	Machine Operator	Press Operator - Metal
Lifting Ability - Light (1-20 lbs)	Lifting Ability - Average (21-40 lbs)	Lifting Ability - Moderate (41-60 lbs)
Lifting Ability - Heavy (61-75 lbs)

Professional

Marketing	Cost Accounting	Quality Manager
Outside Sales	Inside Sales	Executive Administration
Finance	Certified Public Accountant (CPA)	Accountant
Engineer	Journalism/Communication	Human Resources
Consultant	Project Manager	Supervisor
Controller	Purchasing	Manager

Certifications / Licenses(Security Clearance information can be included here)

Type of License:	Issued By:	Exp Date:	License #:

The information I have provided is true and correct to the best of my knowledge. Submitting the form confirms that:

I authorize Spherion to confirm any of the information I have provided, and to obtain employment references and personal history and/or other background information. I also authorize Spherion to disclose and/or release a copy of my personnel/employment records or information, including but not limited to this Application for Employment, reference information, drug screen and criminal background check results, background data, social security number, and any other personnel/employment information to clients to whom I am assigned or submitted for potential assignment. I also expressly release any legal claims I may have against Spherion and any client to whom the information is disclosed or released and their officers, agents and employees, in relation to the disclosure or release of my personnel/employment records pursuant to this authorization.
I consent to Spherion contacting me at any of the telephone numbers or email addresses listed on this Application for Employment or other application forms and to Spherion using automated technology for messaging, including an automated dialer, even if the number or address listed is on a federal or state do-not-call registry.
I understand that any misrepresentation, falsification, or material omission of information in this Application for Employment or other application form may result in my failure to receive an offer of work or termination from employment with Spherion if I am hired.
I agree that my employment relationship with Spherion can be terminated at will either by me or by Spherion, with or without cause, and with or without notice at any time.