Answer all questions. Incomplete or illegible applications may be disqualified. Falsification or deceptive omission of requested information may cause rejection, removal from eligible lists or dismissal.
Personal Information
Last Name
 First
 Middle
 Social Security #
Are you a citizen of the United States: Y or N?
If you are not a citizen, do you have proof of the legal right to work in the United States: Y or N? 		Home Telephone #
Street Address
 City
 State
 Zip
 Cell Telephone #
Position applying for
 Reffered by
 Salary Desired
 Are you at least 18 years old?
Emergency Notification
 Relationship
 Home/Work Phone
 Applicant Email (required)

Employment History
List your last three places of employment, starting with the most recent position. All information must be completed. You may attach a resume, but not in place of completing the required information.
Employed from
 Employer Name
 Supervisor Name
 Starting Salary
Employed until
 Employer Address
 Supervisor Phone
 Ending Salary
Job Title
 Reason for Leaving
Duties & Responsibilities

Employed from
 Employer Name
 Supervisor Name
 Starting Salary
Employed until
 Employer Address
 Supervisor Phone
 Ending Salary
Job Title
 Reason for Leaving
Duties & Responsibilities

Employed from
 Employer Name
 Supervisor Name
 Starting Salary
Employed until
 Employer Address
 Supervisor Phone
 Ending Salary
Job Title
 Reason for Leaving
Duties & Responsibilities

Education
High School
 Location
 Graduate Y or N
 Equivalency Cert. Y or N
College/University
 Location
 Graduate Y or N
 Degree Y or N
Vocational, Business, Other
 Location
 Graduate Y or N
 Certificate Y or N
Other Special Knowledge, Skills, and/or Qualifications

Your Resume

Certification & Authorization
The above information is true and correct. I understand that in the event of my employment by On the Move Staffing Services, I shall be subject to dismissal if any of the information that I have provided in this application is false or misleading or if I failed to give any information herein requested, regardless of the time elapsed after discovery. I authorize On the Move Staffing Services to inquire into my educational, professional, and past employment history references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about myself to On the Move Staffing Services and will hold On the Move Staffing Services and my former employers harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize On the Move Staffing Services to obtain any credit and consumer check.

I understand that nothing in this employment application, the granting of an interview, or my subsequent employment with On the Move Staffing Services is intended to create an employment contract between myself and On the Move Staffing Services under which my employment could be terminated only for cause. On the contrary, I understand and agree that, if hired, my employment will be terminable at will and may be terminated by On the Move Staffing Services or myself at any time and for any reason. I understand that no person has the authority to enter into any agreement contrary to the foregoing.

If employed, I will be required to provide original documents that verify my identity and right to obtain employment in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9.

I hereby acknowledge that I have read and agree to the above statements.

Signature
Date