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Date of Application:
*
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Name
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First
Middle
Last
Date of Birth
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Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
Email
*
Date Available to Start
*
Have you been convicted of a felony?
*
Yes
No
Answering yes to this question will not prevent you from getting employment.
Date of Conviction
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If yes, explain.
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Are you eligible to work in the US?
*
Yes
No
Are you 18 years or older?
*
Yes
No
What is your career path?
*
General Labor
Sales
Maintenance
Commercial Driving
Information Technology
Please choose position closely related to interests and skills/experiences that apply to you personally.
In what area do you need/desire training?
*
None
General Equivalency Diploma (GED)
Resume Building
Interview Training
Google IT
Forklift Operator
Unarmed Private Security
Hospitality
Certified Nursing Assistant
EMS Basic Training
American Heart (BLS Provider)
EMS BLS Provider
First Aid Training
PINQ and its partners would like to extend training opportunities which would make you more desirable in the career market.
Position Desired?
*
Full-Time
Part-Time
Either
Desired Shift?
*
Morning
Evening
Either
How did you hear about us?
*
EMPLOYMENT INFORMATION
(List Present or Most Recent Employer First)
Most Recent Employer
*
Employer Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Name of position & Supervisor
Contact Number
*
Permission to Contact
*
Yes
No
Start Date
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Reason for Leaving?
*
Job Description
*
Next Recent Employer
*
Employer Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Name of position & Supervisor
*
Contact Number
*
Permission to Contact
*
Yes
No
Start Date
*
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Reason for Leaving?
*
Job Description
*
Last Recent Employer
*
Employer Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Name of position & Supervisor
*
Contact Number
*
Permission to Contact
*
Yes
No
Start Date
*
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Reason for Leaving?
*
Job Description
*
EDUCATION AND OFFICE SKILLS
High School
*
Address
Date From
*
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Date To
*
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Did You Graduate
*
Yes
No
College or Trade School
*
Address
Date From
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Did You Graduate?
*
Yes
No
(If you did not attend college, please select no.)
Degree Received
*
(Select none if you did not attend college.)
Office Experience
*
Word
Excel
Access
Powerpoint
Publisher
Not Applicable/None
Name of position & Supervisor
Years of Typing Experience
Words per Minute
REFERENCES
1. Reference Name
*
First
Last
Phone
*
Email
2. Reference Name
*
First
Last
Phone
*
Email
3. Reference Name
*
First
Last
Phone
*
Email
MILITARY SERVICE INFORMATION
Military Service?
*
Yes
No
Prefer Not to Disclose
Are you a veteran?
*
Yes
No
Prefer Not to Disclose
Consent: By selecting above and signing, I hereby certify that the above information, is correct to the best of my knowledge. I understand that falsification of this information may prevent me from being hired or lead to my termination if hired. I also provide consent for my former employers to be contacted regarding work records. I further agree PINQ Staffing LLC may rely on this authorization to order and/run background checks
*
Yes
No
Signature
*
Clear Signature
Date Signed
*
File Upload (Resume)
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File Upload (Other)
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Contact Info
1019 E 54th ST North, Tulsa, OK. 74126
1 918.764.8757
[email protected]
https://pinqstaffing.com