Employment Application

Only First Name, Last Name, and Cell Phone are required.

Last Name * First Name * Middle Name

Street Address Apartment City State ZIP Code Preferred Language Cell Phone * Email Emergency Contact Emergency Phone

Are you at least 18 years old?YesNo

Own transportation?YesNo

Social Security NumberEncrypted before it is stored. Date of Birth Marital Status Gender Total Dependents Education Completed

ID Type ID NumberEncrypted before it is stored. ID Expiration Date

Languages

English Español Other

Are you legally authorized to work in the United States?YesNo

Tell us about the opportunity you are seeking.

Position Applying For Date Available

Type of Employment

Full Time Part Time Seasonal Other

Schedule Restrictions?

Have you ever been convicted of a felony?YesNo

Who referred you to One Services Staffing LLC? Referral Name

List your two most recent jobs. Leave a job section blank if it does not apply.

Job 1

Company Position Supervisor Name Pay Rate Phone Dates Reason for Leaving

Job 2

Company Position Supervisor Name Pay Rate Phone Dates Reason for Leaving

Relevant Experience0/1500 Relevant Skills or Certifications0/1500

Upload a résumé or work history, if available.

Upload Resume or Work HistoryPDF, DOC, or DOCX · 5 MB maximum

Review your information, then sign and date the application.

Signature Date

By signing, you confirm that the information in this application is true and complete to the best of your knowledge.

Thank you for applying.