APPLICATION FOR EMPLOYMENT

Thank you for your interest in joing the ESS Support Services team. To ensure proper consideration, fill in the information below completely and accurately.

Items marked with a * are required responses.

How did you learn of ESS? *

Specify:

First Name *

Last Name *

MI: *

Social Security Number *

Mailing Address *

Apt/Suite No:

City *

State *

Zip Code *

Email Address

Home Phone *

Message/Cell Phone

Position Applied For *

Application Date *

Earliest Date Available *

Min Salary Required *

Over age 18? *

Yes

No

If under age 18, specify age

A conviction is not an automatic bar from employment with ESS Support Services. Omission of any information may result in your application being rejected or may be grounds for termination if hired.

Have you ever plead no contest to, or been convicted of a Felony?

*

Yes

No

If yes, explain

Are you eligible to work in the United States? *

Yes

No

Do you have a valid driving license? *

Yes

No

State

Number

Are you available for? Select all that apply *

Have you ever applied for work with ESS, Eurest or Statewide Services? *

Yes

No

If yes, when? (month /year)

Have you ever been employed by ESS, Eurest or Statewide Services? *

Yes

No

If yes, when? (mo/year)

Location

Position

Were you employed under another name? Indicate

List any relatives working with ESS Support Services

Name

Relationship

Name

Relationship

Give below the names of three persons not related to you whom you have known at least one year

Name

Phone

Address

Business

Years Known

Name

Phone

Address

Business

Years Known

Name

Phone

Address

Business

Years Known

Indicate Highest Level of School Completed *

Name of last school attended

City/State/Country

Degree / Certificate

List/Describe other courses, certificates, licenses

Please complete all of the section, "See Resume" should not be substituted for any section on this application.

Employer

From (MM/YYYY)

To (MM/YYYY)

May we contact employer?

Yes

No

Address

Hourly Rate/Salary Starting

Hourly Rate/Salary Final

Telephone

Reason for Leaving

Job Title

Supervisor

Describe Job Duties Briefly

0/105 characters

Employer

From (MM/YYYY)

To (MM/YYYY)

May we contact employer?

Yes

No

Address

Hourly Rate/Salary Starting

Hourly Rate/Salary Final

Telephone

Reason for Leaving

Job Title

Supervisor

Describe Job Duties Briefly

0/105 characters

Employer

From (MM/YYYY)

To (MM/YYYY)

May we contact employer?

Yes

No

Address

Hourly Rate/Salary Starting

Hourly Rate/Salary Final

Telephone

Reason for Leaving

Job Title

Supervisor

Describe Job Duties Briefly

0/105 characters

Employer

From (MM/YYYY)

To (MM/YYYY)

May we contact employer?

Yes

No

Address

Hourly Rate/Salary Starting

Hourly Rate/Salary Final

Telephone

Reason for Leaving

Job Title

Supervisor

Describe Job Duties Briefly

0/105 characters

Yes

No

Were you employed by any of the above under another name? *

If yes, please indicate

Explain any gaps in employment of 3 months or more and give any other information that you believe would assist us in considering you for employment.

0/240 characters

PLEASE READ VERY CAREFULLY BEFORE SIGNING BELOW

I understand that, the information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any facts in my application, resume and any other materials or during any interviews, can be justified for refusal of employment or, if employed, termination from the Company.

I authorize and request that all of my present and former employers and those individuals I have listed as personal references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment, hereby releasing them from any and all liability for damages arising from furnishing the requested information.

I authorize ESS Support Services Worldwide to use any lawful method, in its sole discretion, it deems reasonable and necessary to determine whether an officer, employee, or agent or potential officer, employee or agent has engaged in conduct that would interfere with or adversely affect the business interests of ESS or to determine whether any officer, employee or agent has engaged in conduct warranting disciplinary action. Such investigation may include, but may not be limited to, safety related inquiries, arrest and criminal record inquiries, financial disclosure, finger printing and credit history inquiries.

In consideration of my employment, I agree to comply with the policies, rules, regulations, and procedures of the company and understand that my employment and compensation can be terminated with or without cause or notice, at any time, at the option of either the company or myself. I further understand that no manager or representative of the company, other than the President has any authority to enter into any agreement with me for employment of any specified period of time or to make any agreement different from or contrary to any company policy. I further understand that any such agreement, if made, shall not be enforceable unless it is in writing and signed by me and by one of the individuals designated above.

I have read, understood and accept my obligations as an applicant. *

Yes

No

If you wish to, please submit a copy of your resume.

Powered by Formsite

Formsite