Job Applicants

Personal Information

Are you at least 18 years of age and do you have the legal right to work in the United States?

First Name  (Required):

Middle Name:

Last Name  (Required):

Nickname / Preferred Name:

Street Address / Apartment:

City:

State / Zip Code:

Home Phone  (Required):
(  ) -  Area code and phone number

Other Phone:
(  ) -  Area code and phone number

Email Address:

Resume - If you have a plain-text resume, paste it into the box below


Availability

Are you willing to work temporary?:

Are you looking for a full-time career position?:

Are you looking for contract positions?:

When are you available to start?:
  ,

What weekday hours are you available?:

What weekend hours are you available?:

How many hours are you willing to work in a week?:

Are you willing to work overtime?:

What is the minimum pay you desire?:
 Hourly rate or annual salary

How much notice will you need if a position is offered to you?:

How many miles are you willing to travel to a position?:

At which of our three locations would you like to be interviewed?:



Education

Enter Most recent - Do not enter start and end date if the most recent is high school
Name of School:

Type of school:

Street Address:

City:

State / Zip:

Start Date (Month / Year):

End Date (Month / Year):

Degree:

Major Study Area:

Other Studies:



Recent Employment

List most recent first
Company Name  (Required):

Street Address:

City  (Required):

State / Zip Code  (Required):

Supervisor Name:

Job Title  (Required):

Job Duties  (Required):

Start Date (Month / Year):

End Date (Month / Year):

Start Wage:
 Hourly rate or annual salary

End Wage  (Required):
 Hourly rate or annual salary

May we contact this employer for a reference check?:
Company Name  (Required):

Street Address:

City  (Required):

State / Zip Code  (Required):

Supervisor Name:

Job Title  (Required):

Job Duties  (Required):

Start Date (Month / Year):

End Date (Month / Year):

Start Wage:
 Hourly rate or annual salary

End Wage  (Required):
 Hourly rate or annual salary

May we contact this employer for a reference check?:
Company Name:

Street Address:

City:

State / Zip Code:

Supervisor Name:

Job Title:

Job Duties:

Start Date (Month / Year):

End Date (Month / Year):

Start Wage:
 Hourly rate or annual salary

End Wage:
 Hourly rate or annual salary

May we contact this employer for a reference check?:

I certify that the statements I have made are true and correct and without material omission. I understand that making false statements or omitting pertinent facts is sufficient cause for rejection or dismissal from employment. I authorize obtaining information from any person(s), employers, educational institutions, licensing authorities, and/or law enforcement agencies concerning my background, work habits, skill or conduct on the job, with the exception of past employer(s) I have indicated that are not to be contacted. I hereby release such person or entities from all liability for damages for issuing such information.

When I am employed I agree that if at any time I make claims for personal injuries, I will submit myself, upon written request, to examination by a physician or physicians of employer's selection, at employer's expense, as often as may be requested.

I also agree that if I am employed, now or at any time in the future, my employment may be terminated at any time without liability to me for wages or salary except for such wages or salary which I earned prior to the date of my termination. I understand the term of my employment shall be limited to the duration of any assignment that I accept.

I am aware that Public Law 91-508, known as the Fair Credit Reporting Act, requires the employer to inform me that a routine inquiry may be made that will provide applicable information concerning my character, my general reputation, my personal characteristics and my credit history. Upon written request, I will provide additional information as to the nature and scope of the inquiry or any report which is produced.

I understand that I am applying for temporary or contract assignments. The completion of this application process shall constitute a conditional offer of employment subject to my availability and the availability of customer assignments calling for the skill and qualifications that I possess, and I agree to consider acceptance of such assignments.

Please take a moment to review your application. Indicate that you have read the above statement by entering your initials in the box below. To complete this application, click on the Submit Application button.

Initials  (Required):


CONSENT AND RELEASE FOR DRUG AND ALCOHOL TESTING

As an employee of United Talent I understand and acknowledge that certain clients of United Talent require persons working at their facilities to submit to drug and alcohol screening programs. I understand and agree that I may be required to take a drug and alcohol test as a condition of a referral to such places of employment. I agree to cooperate with United Talent and any laboratories chosen by United Talent to conduct such screening, analyze the specimens contained and release their findings to United Talent and to any client of United Talent which might require substance abuse screening as a condition of my working at its facilities. I agree that cooperation in the taking of any such substance test may be a condition of any such referral to those places requiring substance screening and that refusal to cooperate with United Talent in the administration of substance abuse policies and testing will be justification for the refusal of United Talent to refer me to any such place of employment which might require drug and alcohol screening. I also acknowledge and agree that I may be required to submit to “for cause” substance abuse testing and random substance abuse testing as to safety sensitive jobs as a condition to remaining employed at any location requiring such substance abuse testing. I also acknowledge and agree that any positive results on any such substance screen, or any attempt to deliberately falsify or not answer a question, or any attempt to adulterate a specimen, will be justification for termination from United Talent. I also release United Talent from any liability arising from any such substance screening or effort at substance screening. I have read, understand and agree to the above.

Initials  (Required):


AGREEMENT

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

I understand the job I am applying for is an employment-at-will position and not a contract for employment. I further understand that United Talent may terminate me at any time without statement of reason and I may quit United Talent for any reason. No contrary implied agreement has been made to me.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the company.



Initials  (Required):


CONFIDENTIALITY STATEMENT

I understand and agree that confidentiality on assignments while employed by United Talent is critical to United Talent and their clients. I further agree not to discuss information I learn of, either heard or seen, with anyone except a Counselor of United Talent. I further agree not to discuss my rate of pay with coworkers or United Talent clients.



Initials  (Required):

United Talent is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with United Talent depends solely on your qualifications.

"United Talent is reliable and consistently finds the right talent for the job!"

Donna Duba
Jackson Kelly

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