Test Form - Hay Residential Services

PERSONAL INFORMATION

First Name *

Last Name

Address *

Phone *

Email *

Social Security Number(SSN)

Date Available

Desired Pay $

HourSalary

Position Applied For *

Employment Desired *Full TimePart TimeSeasonal

PERSONAL INFORMATION

Are you Legally Eligible to work in the US? *YesNo

Have you ever worked for this Employer? *YesNo

If yes write Start Date and End Date

EDUCATION

High School

GraduateYesNoDiploma

College

GraduateYesNoDegree

Other

Others

Address

PREVIOUS EMPLOYMENT

Employers

Employer

Phone

Job Title

Responsibilties

Dates of Employment

Reason for Leaving

REFERENCES

References

Full name

Relationship

Company

Title

Phone

Are you Veteran? *YesNo

MILITARY SERVICES

Branch

Rank at Discharge

Dates of Service

BACKGROUND CHECK CONSENT

If asked, are you willing to consent to a Background Check?YesNo

Please complete each section EVEN IF you decide to attach a resume

No file chosen

DISCLAIMER

Employer provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired.

I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, education and qualifications for employment.

I also authorize you to request and receive such information. In consideration for my employment, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added or interpreted at any time, at the company’s sole option and without prior notice to me.

I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of the company or myself.

I affirm all the above statements are true *YesNo

Date

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