Standard & Custom

Press Leaders

Name(*)

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Date(*)

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Address(*)

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Email Address(*)

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Home Phone(*)

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Mobile Phone(*)

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Are you legally authorized to work in the U.S?(*)

YesNo

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Are you at least 18 years or older? (If no, you may be required to provide authorization to work.)(*)

YesNo

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During the last ten years, have you ever been convicted of a crime other than minor traffic offense?(*)

YesNo

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If yes, please provide details (dates and location for all convictions)

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Have you ever been terminated from employment or asked to resign by an employer?(*)

YesNo

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If yes, please provide company names and details

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Date you can start(*)

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Hourly Rate/Salary desired(*)

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Position desired(*)

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Are you currently employed?(*)

YesNo

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If so may we inquire of your present employer?(*)

YesNo

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PLEASE CHECK SCHEDULE AVAILABILITY (*)

I am available and desire to work FULL-TIME and do not have restrictions on my hours and days. (Complete Section B.) I am available and desire to work PART-TIME (please complete Sections A & B)

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I am only available for PART-TIME because:

StudentOther JobOther (explain)

Explain:

NOTE: WORK SCHEDULES ARE BASED UPON THE NEEDS OF THE BUSINESS AND MAY BE SUBJECT TO CHANGE ON A WEEKLY BASIS.

Can you work overtime, including weekends?(*)

YesNo

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Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation? (*)

YesNo

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How did you hear about us?

Walk InAdvertisementReferralOther

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Have you ever worked for this company before?(*)

YesNo

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Explain

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Do you know anyone who works for our company?

YesNo

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If yes, who?

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Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for?

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Computer Skills (please describe):

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EMPLOYMENT HISTORY: Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

Please read carefully before signing.

ACS Group is an equal opportunity employer. ACS Group does not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

I understand thet neither the completion of this application nor any other part of my consideration for employment establishes any obligation for ACS Group to hire me. If f am hired, I understand that either ACS Group or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of ACS Group has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to ACS Group true and complete information on this application. No requested information has been concealed. I authorize ACS Group to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

ACS Group participates with eVerify. We are committed to compliance with all regulation issued by the Department of Homeland Security.

SignDate(*)

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Signature(*)

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Hours Available	Mon	Tue	Wed	Thu	Fri	Sat	Sun
From:
To:

EDUCATION	Name & Location of School	Years Attended	Degree Received	Subjects studied/Major
High School
College or University
Trade, Business or Correspondence School

From:	To:	Employer Name:	Telephone:
Job Title:		Address:
Immediate Supervisor:		Summarize the nature of work performed and job responsibilities:

From:	To:	Employer Name:	Telephone:
Job Title:		Address:
Immediate Supervisor:		Summarize the nature of work performed and job responsibilities:

From:	To:	Employer Name:	Telephone:
Job Title:		Address:
Immediate Supervisor:		Summarize the nature of work performed and job responsibilities:

Standard & Custom

Press Leaders

Employment Form

Section A

Section B

References

This application is valid only for 60 days from the date signed/dated above.

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