*Name:

Email:

Street Address:

City:

STATE:
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Zip Code:

Telephone Number:

Do you have reliable transportation?
Yes No

If you do not have a car, are you willing to ride with another worker/carpool to and from the job and share in the transportation costs?
Yes No

Work Experience and Skills:
Auto/Truck Mechanic
Clerical
Commerical Driver's Licence (CDL)
Forklift Operator
Furniture Mover
Hotel/Motel/Houskeeping
Clean up and restoration of nataural disasters (fire and flooding)
Inventory/Shipping/Receiving
Janitorial
Landscape Maintenance
Manufacturing/Fabrication
Printing
Resturant
Retail
Warehouse Work

Please list the number of years' experience working in any of the following fields

Construction Skills:
Asphalt/Paving
Carpentry
Carpet Installation
Cement Work
Drywall
Electrical Wiring
Fencing
Heavy Equipment Operation
Masonry (brick/tile/etc.)
Painting
Pipefitting
Plumbing
Welding
Other

Please list the number of years experience working in the following fields

Have you ever worked for a temporary employment service before?
Yes No

If so, which service(s) and what type of work did you do?