Perry Personnel Plus, Inc. Application For Employment Please complete entire application before submitting. Apply Form Name* First Middle Last Suffix Apt/Bldg # Address Street Address City State / Province / Region ZIP / Postal Code Primary Phone #*Message Phone #Minimum Acceptable Hourly Pay Rate How Did You Hear About Perry Personnel? Transportation Bike Car Ride Birthdate MM slash DD slash YYYY Which Perry Personnel Plus Office would you like to contact you?Which Perry Personnel Plus Office would you like to contact you?Three RiversSturgisHave you been convicted of a felony in the past seven years? Yes No If yes, please explain:If yes, State(s) where convicted: Education Level: No Diploma GED High School Diploma Some College College Graduate = Degree Earned Are You Currently Employed? Yes No If currently employed, may we contact your employer? Yes No Are you 18 years of age or older? Yes No Position DesiredPosition DesiredIndustrial/ProductionClerical/ProfessionalAnyEmployment History Current or most recent job firstFrom: MM slash DD slash YYYY To: MM slash DD slash YYYY Company Name City & State Company PhoneSupervisor Name Starting Wage/Salary Ending Wage/Salary Position Held/Duties Reason for Leaving From: MM slash DD slash YYYY To: MM slash DD slash YYYY Company Name City & State Company PhoneSupervisor Name Starting Wage/Salary Ending Wage/Salary Position Held/Duties Reason for Leaving From: MM slash DD slash YYYY To: MM slash DD slash YYYY Company Name City & State Company PhoneSupervisor Name Starting Wage/Salary Position Held/Duties Reason for Leaving Name High School Attended Year Graduated City of High School State Phone #GED Facility Attended Year Graduated City of GED Facility State Phone #Emergency Contact Parent Spouse Name: Home PhoneWork PhoneHave you ever been employed with another service? No Yes = How Long From When to When? Month/Year Pay Rate Name of Service USER AGREEMENT BY CLICKING “YES,” YOU (AS AN INDIVIDUAL AND ON BEHALF OF ANY LEGAL ENTITY YOU REPRESENT) AGREE TO THE TERMS, POLICIES AND PROCEDURES AS EXPLAINED WITHIN THIS APPLICATION WITH PERRY PERSONNEL PLUS, INC., AND AS OF THIS DATE YOU ACKNOWLEDGE THAT YOU HAVE READ AND ACCEPT IT’S TERMS. YOU ARE ALSO REPRESENTING TO PERRY PERSONNEL PLUS, INC. THAT YOU HAVE THE LEGAL AUTHORITY TO ACCEPT THE TERMS OF OUR APPLICATION ON BEHALF OF YOURSELF OR THE PARTY YOU REPRESENT.TYPE THE FOLLOWING CODE INTO THE FORM FIELD TO CONFIRM YOU ARE NOT A ROBOT:210146* Resume UploadMax. file size: 100 MB.Cover Letter UploadMax. file size: 100 MB.NameThis field is for validation purposes and should be left unchanged. Δ
