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Employment
References
Resumé
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First Name

Middle Initial

Last Name

Street

City

State

Postal Code

Email Address

Phone Number

Secondary Phone Number

Are you under 18?

No Yes

Are you a U.S. Citizen? (or have a visa permitting employment)

No Yes

Please choose your desired shifts:

Wage Desired

Annually

Hourly

How did you hear about us?

Please Explain

Have you previously been employed by Kelly Services?

Yes

Have you ever applied at Kelly Services?

Yes

Are you presently employed?

Yes

When Can You Start?

As Soon As Possible

With Notice

Do you have any acquaintances or relatives currently employed by Kelly Services that you would like to use a reference?

Yes

Current Employee References

Have you ever been convicted of a crime or are you subject to any pending arrest, other than for a speeding ticket or similar traffic violation? (The definition of a crime includes misdemeanors, felonies, non-traffic ordinance violations or criminal traffic violations) Please describe and indicate dates. Conviction or arrest will not necessarily disqualify you from employment unless the offense is substantially related to the circumstances of the job for which you're applying.

If you are NOT a high school graduate, have you completed your G.E.D. or H.S.E.D?

No Yes

Type

Name of School

Street

City

State

Postal Code

Average GPA

Graduated

No Yes

Degree Received

Number of Years

Major Field of Study

List and describe any additional education, training, outside activities, hobbies, professional organizational memberships, and skills you have that are not included above. Examples include training programs, seminars, apprenticeships, office equipment, sheet metal, electronic/electrical instruments, measuring devices, shop math, etc.

Have you ever been a member of the United States Military Service?

No Yes

What Branch

Rank at Discharge

Type of Discharge

Start Date of Service

Date of Discharge

Special skills, training or experience acquired in the military Less than honorable discharge will not disqualify you from employment unless the facts surrounding the discharge are substantially related to the circumstances of the job you are applying for

Please provide your work history for a minimum of the last 5 years, starting with your most recent position.

Employment

Name of Company

Your Position

Currently Employed Here

No Yes

Street

City

State

Postal Code

Start Date

End Date

Ending Pay

Annually Hourly

Name of Supervisor

Phone

Briefly Describe Your Duties

Reason for Leaving

Please Explain

May we contact your current employer?

No Yes

Please Explain

Please explain any gaps in your employment history

Please select all that apply involving any additional training that you may have received:

Full Name

Phone Number

Occupation

Employer

Work Relationship

May we contact your references?

No Yes

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Signature of Applicant

Date Signed

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