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EMPLOYMENT APPLICATION For

Lanmark Staffing

An Equal Opportunity Employer
Applicants are considered for all positions without regard to race, color, creed, religion, sex, national origin, age, disability, marital or veteran status, or any other status protected by applicable federal, state, or local law.
Thank you for taking the time to fill out our online employment application! Please fill out this application as completely as possible.

 

Personal Information

Are you at least 18 years of age and do you have the legal right to work in the United States?
Yes No
 
First Name (Required)
Middle Name
Last Name (Required)
Nickname / Preferred Name
Street Address / Apartment  
City
State / ZIP Code     
Mailing Address (if different from above)
Street Address / Apartment  
City
State / ZIP Code     
Home Phone (Required) - Area code and phone number
Cell Phone - Area code and phone number
Email Address
Emergency Contact and Phone
Are you a Veteran?
Yes No

Have you ever been convicted of any crime (including driving violations)? If “Yes,” state the nature of the offense, where and when it occurred, the sentence imposed, and any further information you would like us to know.
 
Yes No
I would prefer to work for clients that do not require a drug screen   Yes No

How did you hear about us?

Availability

Are you looking for Temporary?
Yes No
Are you looking for Temp-to-Hire?
Yes No
Are you looking for Direct Hire?
Yes No
When are you available to start?     
What weekday hours are you available?
What weekend hours are you available?
How many hours are you willing to work in a week?  
Are you willing to work overtime?
Yes No
What is the minimum pay you desire? Hourly rate or annual salary
How much notice will you need if a position is offered to you?
Do you have reliable transportation?
How many miles are you willing to travel to a position?
     

Education

Name of School
Type of school  
Street Address
City  
State / ZIP Code   
Start Date (Month / Year)   
End Date (Month / Year)   
Degree  
Major Study Area
Other Studies

Name of School
Type of school  
Street Address
City  
State / ZIP Code   
Start Date (Month / Year)   
End Date (Month / Year)   
Degree  
Major Study Area
Other Studies

Recent Employment

List most recent first
Company Name
Street Address
City
State / ZIP Code   
Company Phone - Area code and phone number
Supervisor Name
Supervisor email address
Job Title  
Job Duties  
Start Date (Month / Year)      
End Date (Month / Year)   Leave blank if currently employed
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
Reason For Leaving
Did you give a notice?
Yes No
If yes, how long?
Did you work through your notice?
Yes No
Your name when employed, if different than present name:
May we contact this employer for a reference check?
Yes No

Company Name
Street Address
City
State / ZIP Code   
Company Phone - Area code and phone number
Supervisor Name
Supervisor email address
Job Title  
Job Duties  
Start Date (Month / Year)     
End Date (Month / Year)   
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
Reason For Leaving
Did you give a notice?
Yes No
If yes, how long?
Did you work through your notice?
Yes No
Your name when employed, if different than present name:
May we contact this employer for a reference check?
Yes No

Company Name
Street Address
City
State / ZIP Code   
Company Phone - Area code and phone number
Supervisor Name
Supervisor email address
Job Title  
Job Duties  
Start Date (Month / Year)     
End Date (Month / Year)   
Start Wage Hourly rate or annual salary
End Wage Hourly rate or annual salary
Reason For Leaving
Did you give a notice?
Yes No
If yes, how long?
Did you work through your notice?
Yes No
Your name when employed, if different than present name:
May we contact this employer for a reference check?
Yes No

 

I hereby certify that the information I have provided in this employment application is true and correct to the best of my knowledge, and that I have not withheld information that would, if disclosed, affect this application unfavorably. I understand that falsified or intentionally misleading information in any detail or significant omissions from this application may disqualify me from further consideration for employment, or may result in my termination if discovered after my hire.

I understand that my employment is “at will,” and can be terminated for any reason, with or without notice.

Please take a moment to review your application.  Indicate that you have read the above statement by entering your initials in the box below.  To complete this application, click on the Submit Application button.
Initials:    


This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.