Applynow2 - Guardian Angel Staffing Agency

Equal Employment Opportunity Employer

All persons should have the opportunity to be considered for employment without regard to their race, color, religion, national origin or ancestry, handicap or disability, sex, marital status, obligations to serve in the armed forces of the United States, citizenship, or any other characteristic protected by applicable federal or state law.

Address*

Street Address City State / Province / Region ZIP / Postal Code

Telephone AM*

Telephone PM*

Your Email *

Position(s) Applied For*

Salary Desired*

Are You Applying For*

Full Time
Part Time
Temporary
Regular
Summer Employment

If seeking part time work, specify the number of days per week

How soon are you available to begin employment

Shift Preference*

Day
Evening
Night

If Preferred shift is unavailable, will you work?

Day
Evening
Night

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

Yes
No

Are you 18 or older?*

Yes
No

Have you ever been convicted of any crime other than a minor traffic violation?*

Yes
No

Please describe the nature of the crime and your subsequent rehabilitation

A criminal conviction will not necessarily be a bar to employment

Have you ever been disciplined for resident/patient abuse?*

Yes
No

Have you ever been employed by this company?*

Yes
No

If yes, list the dates, position and department employed

How were you referred?

Referral Notes:

If friend/relative, please list names

Record of Education

Highschool Name & Address*

Courses Taken

Did you Graduate?*

Yes
No

If So, When?