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Industrial Application
Personal Data  * Required information 
SSN Number:* (xxx-xx-xxxx)
Date of Birth:* (MM/DD/YYYY)
First Name:*
Middle/Maiden:
Last Name:*
Address1:*
Address2:
City:*
State:*
Zip:*
Home Phone:* (xxx-xxx-xxxx)
Cell Phone: (xxx-xxx-xxxx)
Work Phone: (xxx-xxx-xxxx) Ext:
Email:
Emergency Contact Name: 
Phone: (xxx-xxx-xxxx)
Have you ever been convicted of a crime? *
If yes,
give details:
How did you hear of us?
Referred By:
Have transportation?
Do you smoke?
Drivers License Number:
Type of Position: Temporary Permanent Temp To Perm
Date Available: (MM/DD/YYYY)
Days Available: Monday Tuesday Wednesday Thursday FridaySaturday  Sunday
Positions Desired (1):
Positions Desired (2):
Least Acceptable Salary:
Salary Desired:
Education
School:
City:
State:
Major/Minor:
Grade Average: out of
Degree Received:
Date Attended: thru (MM/YYYY)
School:
City
State:
Major/Minor:
Grade Average: out of
Degree Received:
Date Attended: thru (MM/YYYY)
School:
City:
State:
Major/Minor:
Grade Average: out of
Degree Received:
Date Attended: thru (MM/YYYY)
Work Experience Last 10 years
Dates: to (MM/YYYY)
Employer:
City:
State:
Type of Business:
Phone: Ext: (xxx-xxx-xxxx)
Job Title:
Reason for Leaving:
Dates: to (MM/YYYY)
Employer:
City
State:
Type of Business:
Phone: Ext: (xxx-xxx-xxxx)
Job Title:
Reason for Leaving:
Dates: to (MM/YYYY)
Employer:
City
State:
Type of Business:
Phone: Ext: (xxx-xxx-xxxx)
Job Title:
Reason for Leaving:
Skills   (Select up to 10 )
Auto MechanicBack HoeCement FinishCleaning People
Commercial Painting EstimatingCommercial Painting ExperienceCommercial Spackling ExperienceDelivery
Dock WorkDrill OperationDrywall taping/muddingElectrical installation
Food Prep.Food ServiceForkliftFront End Load
General LaborGluing MachineHandtoolsHardware
Heavy LiftingHousekeepingHydralicsInstrument
Lathe MachineLawn MaintenanceLifting (Light to Medium)Maintenance Man
Manufacturing AssemblyMaritimeNon-Medical LabPacking
Page MillPainter 5PlumbingPneumatics
Programmable Logic ControllersPunch PressReceivingRepair
SandblastSealing MachineShippingShipping
Tool/DieTruck Driving ExperienceUnionWiring
Work Ticket: BootsWork Ticket: GlovesWork Ticket: Hard HatWork Ticket: Other (1)
Work Ticket: Other (2)Work Ticket: Safety BeltWork Ticket: Safety GlassesWork Ticket: Shirt
Work Ticket: Transportation ChargesWork Ticket: VestWrappingtextureMaker 
Resume   (Copy and paste your resume in the text box)
 

Copyright © 2006 Career Adventures Inc.
 324 Fort Street Shreveport, LA 71101
(318) 226-WORK (9675)