APPLICATION FORM

Thank you for taking the time to complete our online application. It is the quickest way for us to start evaluating your qualifications for positions now and in the future. Once we have completed our preliminary assesment, you may be contacted for further information.

First name:
Middle initial:
Last name:
Nickname:
Address / PO Box:
City / State / Zip:
Phone:
Message phone:
Email:

Check preferred location for work

Boulder County Boulder (city) Broomfield Denver (North)

Denver (South) Gunbarrel (Boulder) Lafayette/Louisville Longmont

How did you hear about us?

Minimum hourly wage required

Do you have your own reliable transportation?   Yes    No 

Do you speak any other languages?   Yes    No 
If so, which?

Apply the numbers 1 and 2 next to your primary and secondary choices of employment:
Accounting
Clerical/secretarial
Computer
General labor
Industrial/assembly
Professional/technical
Other/miscellaneous - type

Dates available: from  to 

Days available (check any or all):
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Hours available: from  to 

Positions you are looking for? (check any or all):
Full-time
Part-time
Temp-to-hire
Direct-hire (work directly for employer)

Are you over 18?   Yes    No 


Check any or all of the employment categories in which you have at least some experience.

Administrative, Clerical & Special Projects
	Accounting
	Accounts payable/receivable Assistant clerk Bookkeeping Controller Depreciation	Financial statement General ledger Payroll Quarterly reports/taxes Tax returns
	Clerical/General Addressing, coding, copying, collating, fax, file clerk (alpha/numeric) Mail room
	Clerical/Receptionist Number of telephone lines Number of telephone extensions
	Clerical Secretarial 10 key by sight (wpm) 10 key by touch (wpm) Shorthand (wpm) Data entry Executive Legal Letter composition/proofreading Medical Transcription Travel arrangements Word processing
Industrial & General Labor
	Assembly Cable assembly Clean room Failure analysis Mechanical assembly Assembly production - type Quality assurance - type Quality control - type Soldering-surface mount Soldering-thru-hole Lead supervisor Technician Test operator
	General Labor
	Commercial driver's license Driver-auto/van Driver-truck/multi-axle Forklift experienced	Forklift certified Inventory/stockroom Manifest system Shipping/receiving/warehouse
	Maintenance
	Janitorial/housekeeping	Landscaping
	Miscellaneous Processing
	Band saw Chemical processing CNC machinist Electroplating Food processing Glass processing	Industrial sewing Journeyman machinist Metal processing Plastic processing Textile Wood processing
	Printing
	Bindery Layout	Pressman Typesetting
	Miscellaneous
	Bakery Bartender Bank teller Carpentry Cashier Chef/cook Customer service	Desk clerk Demonstrator Food prep Wait staff/restaurant/catering Sales/retail Telephone sales/survey
Technical (IT) & Professional
	Hardware Experience
	IBM or compatible Macintosh Own my own computer
	Software Experience
	Accounting/finance CAD/CAM Communication Database Graphic/photo/web	Internet/email Mail merge Presentation Spreadsheet Word processing
	List all programs/applications with which you are familiar and rate yourself on a scale of 1 to 5 for your software experience; 1 = beginning experience 5 = expert experience Example: Microsoft Word (4), PowerPoint (3)
	Programming Experience
	Which computer systems are you familiar with?
	Which computer languages are you familiar with?
	Which computer interfaces are you familiar with?
	Do you have any other computer-related experience?
	Other Professionals
	Architect Banking Credit analyst Drafting Engineering Finance/investment Graphic design Human resources	Insurance Legal Management Medical/health Purchasing Sales Technical writing

Education
	High school diploma or GED
	College Major & degree Number of years attended?
	Graduate/post graduate Specify degree
	Trade/technical school Certification/degree Number of years attended?

Have you ever worked for a temporary service?   Yes    No 

Which services?

Companies assigned to:

Types of work performed:

Employment
Most recent employer
Address
City/State/Zip
From (month/year)
To (month/year)
Wage
Supervisor
Phone
Email
Reason left
Duties
Previous employer
Address
City/State/Zip
From (month/year)
To (month/year)
Wage
Supervisor
Phone
Email
Reason left
Duties

Personal References

Name
Phone
Years known
Name
Phone
Years known

Comments:

By submitting this application, you agree to the following consent and release statements. Please read these statements carefully before submitting.

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal at a later date.

I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment drug screen as a condition of employment, if required. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre-employment physical examination. I consent to the release of any or all information as may be deemed necessary to judge my capability to do work for which I'm applying.

I understand that this application, verbal statements by management, or subsequent employment does not create an express or implied contract of employment nor guarantee employment for any definite period of time, only the president of the organization has the authority to enter into an agreement of employment for any specified period and such agreement must be made in writing, signed by the president and the employee. If employed, I understand that I have been hired at the will of the employer and my employment may be terminated at any time, with or without reason and with or without notice.

This application for employment will remain active for six months.

© 2007 Bolder Staffing, Inc.