APS Application

Application For Employment (At-Will)

APS EMPLOYMENT SERVICES, INC.

This Company is an equal opportunity employer and will not discriminate against any applicant on the basis of any characteristic that is protected by State or Federal law. Michigan law requires that a person with a disability or handicap requiring accommodation to perform the essential duties of the job must notify the employer in writing within 182 calendar days of the date that the need is known or should have been known.

General Information

The following questions gather your personal info. and collect responses to your preferences and current employment status.
Position Applied For: *
Date of Application: *
Date You Can Start: *
First Name *
Last Name *
Middle Initial *
Street *
City *
State *
Zip *
Email Address
Home Phone *
Cell Phone
Are you 18 years or older? *YesNo
Are there days you cannot work? if yes, list them:
Salary Desired: *
Type of Employment: *Full-timePart-time
Are you employed now? *YesNo
May we contact your present employer?YesNo
Name, title, and phone number of current employer:
Have you ever applied to this company before? *YesNo
Under what name?
When?

Education

The following questions pertain to your educational background and military experience. Please note that only Elementary and High School information is required for education.
Elementary Education
Elementary school Name and Location *
No. of Years Attended *
Did You Graduate? *YesNo
High School Education
High School Name and Location *
No. of Years Attended *
Did You Graduate? *YesNo
College Education
College Name and Location
No. of Years Attended
Did You Graduate?YesNo
Subject/Major
Specialized Training
Specialized Traning Name and Location
No. of Years Attended
Did You Graduate?YesNo
Subject/Major
If you have friends or family working with us, please list them
Military Experience
Do you have US Military experience?YesNo
Date Entered:
Branch
Rank
Date Discharged
Discharged Honorably?YesNo

Legal status

The following responses will ensure we are able to hire you in accordance with US law.
Are you lawfully entitled to be employed in the US *YesNo
Have you ever been convicted of a crime except a minor traffic violation? *YesNo
If yes, please state citation, date, and place it occured
Please provide any additional information such as special skills, training, management experience, equipment operation or qualifications you feel will be helpful to us in considering your application.

References

Please list three individuals not related to you, whom you have known for at least one year.
Reference 1 *
Name *
Address and Telephone *
Relationship *
Years Acquainted *
Reference 2
Name
Address and Telephone
Relationship
Years Acquainted
Reference 3
Name
Address and Telephone
Relationship
Years Acquainted
Emergency Contact
Name
Address
Telephone

Current and Former Employers

Please list your most recent employers first.
Employer 1
From
To
Employer Name, Address, and Telephone
Salaray Starting/ Ending
Last Position Held/ Responsibilities
Reason for Leaving
Employer 2
From
To
Employer Name, Address, and Telephone
Salary Starting/ Ending
Last Position Held/ Responsibilities
Reason for Leaving
Employer 3
From
To
Employer Name, Address, and Telephone
Salary Starting/ Ending
Last Position Held/ Responsibilities
Reason for Leaving
Employer 4
From
To
Employer Name, Address, and Telephone
Salary Starting/ Ending
Last Position Held/ Responsibilities
Reason for Leaving
Contact Permissions
May we contact the employers listed? *YesNo
If not, which ones?
If applying for a driving position, please list any points or violations on your driving record

Release Statment

Please read the following statement carefully before initialing to indicate your understanding.

To ensure the safety of our employees and our client's employees, all APS employees are prohibited from using drugs on and off the client or APS premises. As a part of this policy, drug and alcohol testing may be required in the following situations: Pre-Employment, Random testing, if your involved in an accident, for an injury or if employee exhibits signs of probable cause to believe he/she is intoxicated.

I understand that, prior to being offered employment, I may be requested to take an employment examination. In the event that I have a disability that will affect my ability to take the test, I will so inform the Company prior to the test so that a reasonable accommodation can be made. The Company reserves the right to require medical documentation regarding the need for accommodation.

I certify that the facts contained in this application are true, accurate, and complete to the best of my knowledge and understand that, if employed, falsified statements or omitted material facts on this application may result in my disqualification from consideration for employment, or termination from employment if I have been hired.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated with or without cause, at any time, with or without notice. This provision supersedes any oral or written representation to the contrary unless in writing and signed by both the President of the company and the person to whom the writing is directed.

I authorize investigation of all statements contained in this application for any employment-related purpose. I release the listed references and all employers, except those specifically excepted,* to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to the Company and waive any right that I might have to be provided with notice that they are releasing this information.
Initial Below
By typing your initials into this text box, you are agreeing to the above statement *

Application For Employment (At-Will)

APS EMPLOYMENT SERVICES, INC.

General Information

Education

Legal status

References

Current and Former Employers

Release Statment