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The Stafford Companies: Resume Builder

Equal Access to programs, services and employment available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.

If you have your resume in electronic format, please "copy" it and then "paste" it into the box at the bottom of this page.

Position(s) applied for :

Date of Application :
Name :
Street :
City / State / Zip :
Phone :
Mobile/Other Phone :
E-mail :

If you are under 18, and it is required, can you furnish a work permit?

yes no

If no, please explain:

Have you ever been employed here before?

yes no

If yes, give dates and potions:

Are you legally eligible for employment in this country?

yes no

Date available for work.

What is your desired salary range? $

Type of employment desired?
Full-Time Part-Time Temporary Seasonal Educational Co-Op

Are you able to meet the attendance requirements of the position?

yes no

Have you ever pled "guilty" or "no contest" to, or been convicted of a crime?

yes no

If yes, please provide date(s) and details.

Answering "Yes" to these questions does not constitute an automatic bar to employment. Factors such as date of the offence, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

Driver's License number if driving is an essential job function.

State of Issue:

Employment History

Provide the following information of your past four (4) employers, assignments or volunteer activities, starting with the most recent.

From: To:	Starting Job Title Final Job Title
Reason for leaving?	Immediate Supervisor and Title

May we contact your supervisor at this company for a reference? Yes No Later

Employer :	Telephone:
Address:
Summarize the nature of work performed and job responsibilities:
Hourly Rate / Salary: Start	Final

From: To:	Starting Job Title Final Job Title
Reason for leaving?	Immediate Supervisor and Title

May we contact your supervisor at this company for a reference? Yes No Later

Employer :	Telephone:
Address:
Summarize the nature of work performed and job responsibilities:
Hourly Rate / Salary: Start	Final

From: To:	Starting Job Title Final Job Title
Reason for leaving?	Immediate Supervisor and Title

May we contact your supervisor at this company for a reference? Yes No Later

Employer :	Telephone:
Address:
Summarize the nature of work performed and job responsibilities:
Hourly Rate / Salary: Start	Final

From: To:	Starting Job Title Final Job Title
Reason for leaving?	Immediate Supervisor and Title

May we contact your supervisor at this company for a reference? Yes No Later

Employer :	Telephone:
Address:
Summarize the nature of work performed and job responsibilities:
Hourly Rate / Salary: Start	Final

Skills and Qualifications

Summarize and training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying:

Educational Background (if job related)

Name & Location	Number of Years Completed	Did You Graduate	Course of Study
High School:
College:
Other:

References

Name	Telephone	Number of Years Known

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with the employer is true and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (1) cancel further consideration of this application, or (2) immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, it's representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, it's agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I an free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period of definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I CERTIFY THAT I HAVE READ, FULLY UNDERSTAND AND ACCEPT ALL TERMS OF THE FOREGOING APPLICANT STATEMENT. yes no

Please submit your resume in the text box provided below by copying from the program you created it (Word, WordPerfect, etc.) and then pasting it into the space provided below.