Employment application[1]
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Employment application[1]

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Employment application[1] Employment application[1] Document Transcript

  • Application for EmploymentAPPLICATION DATE: ______/______/______ Addison Recruiter _______________________Social Security #: ________/_____/_______ Email: ____________________________________Last Name: _________________________ First Name: _____________________ Middle: ________Address: __________________________________________________________City: ___________________ State: ___________ Zip: ____________Home #:_____________________ Work #: __________________ Cell Phone #: __________________Personal URL: _________________________________Have you worked as a temporary /contract employee? Yes No Name of Staffing Dates Companies Supervisor’s Title Salary Firm worked for NamePay per hour: Minimum $________ Most Recent $_______Pay per year: Minimum $________ Most Recent $_______Are you legally eligible for employment in this country? Yes NoDate Available for Work: ____________________ Will you work over-time if required? Yes NoAre there any days/times you are not available? ______________________________________________Have you ever pled “guilty” or “no contest” to, or been convicted of a crime? Yes NoIf yes, please provide date(s) and details:ANSWERING “YES” TO THESE QUESTIONS DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT. FACTORS SUCH AS DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OFTHE VIOLATION, REHABILATION AND POSITION APPLIED FOR WILL BE TAKEN INTO ACCOUNT. ADDISON SEARCH ADMINISTRATIVE IS AN EQUAL OPPORTUNITY EMPLOYER 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 1 Phone: 312-425-0200 - Fax: 312-425-0210
  • JOB CODE: (Recruiter’s Use Only) Skills and Experience Please circle the areas in which you have experience:Software IndustriesAccess Advertising Law FirmACT! Agency LeasingAcrobat Architect ManufacturingADP Biotech MarketingDreamweaver Banking Mutual FundExcel Brokerage Non-ProfitFile Maker Pro Broadcasting Oil & GasIllustrator Collection Agency PharmaceuticalInDesign Consulting Non-CPA Property ManagementLotus Notes Construction PublishingMAC Delivery Public RelationsOutlook Distribution Real EstatePageMaker E-Commerce RetailPeopleSoft Education RetirementPhotoshop Energy Service MiscPowerPoint Engineering SoftwarePublisher Entertainment TradingQuark Environmental TravelQuickBooks Financial Service UtilityQuicken Food Service Venture CapitalWord Government Waste DisposalWordPerfect Healthcare Wholesaler Hospitality Import/Export Insurance InvestmentArea Desired:LOOP CITY NORTH CITY SOUTH CITY WEST N. SUBURBS S. SUBURBS W. SUBURBSDo you have access to a car? YES NO Languages Spoken:Type of Employment Desired: Direct Hire Temporary Temp-to-hire ALL 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 2 Phone: 312-425-0200 - Fax: 312-425-0210
  • Educational BackgroundStarting with your most recent school attended, provide the following information: School (Include City and State) Years Degree Earned Graduation Date CompletedEmployment HistoryStarting with your most recent employer, assignments or volunteer activities provide the following information:Employer: ___________________________________ Job Title: ________________________________________Address: _______________________________________________________________________________________Immediate Supervisor: ___________________________ Phone Number: _____________________________Dates Employed: From ________/________ to ________/________ Salary___________________________Reason for Leaving: _____________________________________ Call for Reference Yes NoEmployer: ___________________________________ Job Title: ________________________________________Address: _______________________________________________________________________________________Immediate Supervisor: ___________________________ Phone Number: _____________________________Dates Employed: From ________/________ to ________/________ Salary___________________________Reason for Leaving: _____________________________________ Call for Reference Yes NoEmployer: ___________________________________ Job Title: ________________________________________Address: _______________________________________________________________________________________Immediate Supervisor: ___________________________ Phone Number: _____________________________Dates Employed: From ________/________ to ________/________ Salary___________________________Reason for Leaving: _____________________________________ : Call for Reference Yes No 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 3 Phone: 312-425-0200 - Fax: 312-425-0210
  • Professional ReferencesTo complete our registration process, and assist us in your employment search, please list as manyprofessional references as possible (Including Direct Supervisors, Indirect Supervisors, Co-Workers andSubordinates). Attach additional sheets as necessary. Where did you What company Current May we work with this Title do they work for Name Relationship now? Telephone Call? person? Direct Supervisor Indirect Supervisor Co-Worker Y N Subordinate Direct Supervisor Indirect Supervisor Co-Worker Y N Subordinate Direct Supervisor Indirect Supervisor Co-Worker Y N Subordinate Direct Supervisor Indirect Supervisor Co-Worker Y N Subordinate Direct Supervisor Indirect Supervisor Co-Worker Y N Subordinate Direct Supervisor Indirect Supervisor Co-Worker Y N Subordinate Direct Supervisor Indirect Supervisor Co-Worker Y N SubordinatePeer ReferencesList the name and telephone number of peer references.Name Title Relationship to Candidate Telephone Years KnownHow did you hear about us? Referred by ____________________________ Craig’s List Walk-in Web-Site Monster CareerBuilder Cold Call Linked In OtherEmergency Contact Name: __________________ Phone #:_______________ Relationship__________ 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 4 Phone: 312-425-0200 - Fax: 312-425-0210
  • RECRUITER USE ONLY:Current Job Title ___________________________________Interview Summary: _____________________________________________________________________Interview Notes:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Word Excel PowerPoint ACCESS OutlookOverall _____ _____ _____ ______ _____Basic _____ _____ _____ ______ _____Intermediate _____ _____ _____ ______ _____Advanced _____ _____ _____ ______ _____Typing __________ Data Entry __________ Actor Human Resources Admin/Receptionist Inside Sales Accounts Payable Law Clerk Accounts Receivable Legal Secretary Accounting Assistant Litigation Support Administrative Assistant Mailroom Benefits Marketing Call Center Market Research Clerk NORC CODER- NORC Office Manager Customer Service Paralegal Data Entry Prompter- NORC Editors Public Relations Event Planner Reception Executive Assistant Recruiter Facilities Manager Registration Fresh Grad Sales Assistant Graphics Word Processor 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 5 Phone: 312-425-0200 - Fax: 312-425-0210
  • Background Investigation Consent FormI, _________________________, hereby authorize Addison Search Inc. and/or its agents to make an independentinvestigation of my background, references, character, past employment, education, and any other relevant informationfor the purpose of confirming the information contained on my application and/or obtaining other information whichmay be material to my qualifications for employment.I release from liability and hold harmless Addison Search Inc., my previous employers, and any other third parties whoprovide information pursuant to this authorization, along with their respective officers, directors, employees, andagents.The following is my true and complete legal name, and all information is true and correct to the best of my knowledge:Full Name (Printed) SSN - -Maiden Name or Other Names Used Please list every address of residence for the last 7 yearsPresent AddressCity State Zip CodeHow long have you lived at this address?Past AddressCity State Zip CodeHow long have you lived at this address?Past AddressCity State Zip CodeHow long have you lived at this address?Applicant Signature Date / / Note: A copy of this signed Consent Form shall be as effective as the original. 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 6 Phone: 312-425-0200 - Fax: 312-425-0210
  • Application for Employment for Addison Search AdministrativeI certify that all information I have provided in order to apply for and secure work with Addison SearchAdministrative is true, complete and correct.I expressly authorize, without reservation, Addison Search Administrative, its representatives, employees oragents to contact and obtain information from all references (personal and professional), employers, publicagencies, licensing authorities and educational institutions and to otherwise verify the accuracy of allinformation provided by me in this application, resume or job interview.I herby waive all rights and claims I may have regarding Addison Search Administrative, its agents,employees or representatives, for seeking, gathering and using such information in the employment processand all other persons, corporations or organizations for furnishing such information about me.I hereby authorize Addison Search Administrative and/or its agents to make an independent investigation ofmy background and credit history.I understand that Addison Search Administrative does not unlawfully discriminate in employment and noquestion on this application is used for the purpose of limiting or excusing any applicant from considerationfor employment on a basis prohibited by applicable local, state or federal law.I also understand that if I am hired, I will be required to provide proof of identity and legal authority to workin the United States and that federal immigration laws require me to complete an I-9 Form in this regard.I hereby agree that I have been notified of all policies and procedures required for successful employmentwith Addison Search Administrative. I further testify that I fully understand and agree to these policies andthe terms of my employment with Addison Search Administrative.Also, by signing below, I acknowledge that I have been notified that failure to contact Addison SearchAdministrative within 48 hours after the end of my assignment and once per week thereafter, may affect myeligibility for unemployment insurance. I understand that any information provided by me that is found to be false, incomplete ormisrepresented in any respect, will be sufficient cause to (i) cancel further consideration of thisapplication, or (ii) immediately discharge me from the employer’s service, whenever it is discovered.DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT:I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.Signature of Applicant________________________________________ Date: ________________ 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 7 Phone: 312-425-0200 - Fax: 312-425-0210
  • Addison Search Employment Agreement (Candidate Copy)Welcome to Addison Search Administrative. We look forward to assisting you in your current job search.The following is a list of policies and procedures required by all Addison Search employees who contract/temp at an AddisonSearch client:WHEN TO CALL YOUR RECRUITER:*When you are unable to make it in to your job for ANY reason. Leave a message on our general voicemail box if you cannotreach anyone.*When you are running late or have to leave your assignment early.*When you arrive at your assignment on your 1st day.*When you are unable to complete the job to which you have been assigned (See “Notice” Below)*When you are offered permanent employment at the assignment.*When you need to talk about any problems related to your present assignment.*When you want to refer friends or co-workers to us so you may receive your referral bonus.NOT ACCEPTABLE:*Using the company phone for personal calls*Using cellular phones and/or having them turned on while at the client site.*Having pagers activated while at the client site.DRESS ATTIRE:Each company has their own dress code policy. Please ask your recruiter what the appropriate attire is for each assignment prior tostarting an assignment.BREAKS:Lunch breaks and regular breaks are to be determined by the manager of the assignment. You should follow the guidelines of thecompany where you are working.TIMECARDS:*Timecards are due by Noon each Monday in order to be paid for the week. FAX copies are acceptable for the purpose ofreporting hours.All checks will be sent out Wednesday evening.*Direct Deposit is also available for your convenience. You must fill out a form that will be submitted with the payroll.NOTICE:In order to maintain the high level of professionalism that Addison Search’s clients have come to expect, we require a MINIMUM1 week notice be given when leaving a contract/temp assignment. In order to recoup the cost of replacing the assignment and thecost of any training credits given to the client, Addison Search reserves the right to pay any hours worked in your final week at theminimum hourly rate allowable by law. This will take effect only in the event that the minimum 1-week notice is NOT given. Wewish you the best of luck in your current job search. All of us at Addison Search pledge to do whatever we can to assist you infurthering your career.I hereby agree to the policies set forth in this agreement.___________________________ ______________________________Signature Addison Search Representative____________________________ ________________Printed Name Date 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 8 Phone: 312-425-0200 - Fax: 312-425-0210
  • Addison Search Employment Agreement (Recruiter Copy)Welcome to Addison Search Administrative. We look forward to assisting you in your current job search.The following is a list of policies and procedures required by all Addison Search employees who contract/temp at an AddisonSearch client:WHEN TO CALL YOUR RECRUITER:*When you are unable to make it in to your job for ANY reason. Leave a message on our general voicemail box if you cannotreach anyone.*When you are running late or have to leave your assignment early.*When you arrive at your assignment on your 1st day.*When you are unable to complete the job to which you have been assigned (See “Notice” Below)*When you are offered permanent employment at the assignment.*When you need to talk about any problems related to your present assignment.*When you want to refer friends or co-workers to us so you may receive your referral bonus.NOT ACCEPTABLE:*Using the company phone for personal calls*Using cellular phones and/or having them turned on while at the client site.*Having pagers activated while at the client site.DRESS ATTIRE:Each company has their own dress code policy. Please ask your recruiter what the appropriate attire is for each assignment prior tostarting an assignment.BREAKS:Lunch breaks and regular breaks are to be determined by the manager of the assignment. You should follow the guidelines of thecompany where you are working.TIMECARDS:*Timecards are due by Noon each Monday in order to be paid for the week. FAX copies are acceptable for the purpose ofreporting hours.All checks will be sent out Wednesday evening.*Direct Deposit is also available for your convenience. You must fill out a form that will be submitted with the payroll.NOTICE:In order to maintain the high level of professionalism that Addison Search’s clients have come to expect, we require a MINIMUM1 week notice be given when leaving a contract/temp assignment. In order to recoup the cost of replacing the assignment and thecost of any training credits given to the client, Addison Search reserves the right to pay any hours worked in your final week at theminimum hourly rate allowable by law. This will take effect only in the event that the minimum 1-week notice is NOT given. Wewish you the best of luck in your current job search. All of us at Addison Search pledge to do whatever we can to assist you infurthering your career.I hereby agree to the policies set forth in this agreement.___________________________ ______________________________Signature Addison Search Representative____________________________ ________________Printed Name Date 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 9 Phone: 312-425-0200 - Fax: 312-425-0210
  • Addison Search contract employees are eligible for the following benefits: HEALTH INSURANCEAll Addison Search contract employees shall be eligible for medical and dental benefits once he/she has worked a total of720 hours. The qualifying employee will be eligible to enroll for health and/or dental insurance coverage immediatelyfollowing the qualification period and coinciding with the next immediate enrollment cycle. Addison Search shallcontribute per week towards an employee’s medical health insurance; employees are responsible for any costs over thisamount.. A fee schedule for extra coverage may be found below. Employees with domestic partners are able to enrollhim/her as a spouse; when enrolling with this option, please contact Human Resources for a Domestic Partner form. Blue Cross Medical Insurance cost per week to employee: Benefits HMO PPO Select PPO Single subscriber (Addison Employee) $6.55 $13.55 $20.62 Employee + Spouse/ $86.03 $101.51 $117.13 Domestic Partner Employee + 1 Child $81.68 $96.69 $111.85 Employee + 2 or more Dependants $161.15 $184.05 $208.37 Guardian Dental Insurance cost per week to employee: Benefits DMO PPO/Value Plan Single subscriber (Addison Employee) $3.79 $8.90 Employee + 1 Dependent $7.19 $17.09 Employee + 2 or more Dependants $11.10 $26.07***Employees outside of the state of Illinois are not eligible to enroll in the Blue Cross HMO or PPOSelect plans, or the Guardian DMO plan. All Addison Search employees health insurance is only effective through the Sunday following their final day of work. COBRA information will be sent to the employee as soon as their end date is processed. LTD AND LIFE INSURANCELong Term Disability and Life insurance are available on a voluntary basis to Addison Search employees throughGuardian. Coverage is based on an employee’s chosen benefit rates, annual compensation, and willingness to participate.Coverage is portable and employees may choose to discontinue participation at any time.Enrollment periods are concurrent with health insurance enrollment; employees are eligible to enroll effective the first ofthe month after the employee has worked a total of 720 hours. 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 10 Phone: 312-425-0200 - Fax: 312-425-0210
  • 401KAll Addison Search employees over the age of 21 shall be eligible for 401k benefits after one year of employment.Enrollment periods are the first check date of each quarter.Employees may contribute up to 50% of their income to Addison Search’s 401(k) plan, not to exceed $15,500 in onecalendar year (subject to change, depending on federal allowances). Addison Search will match at 100% the first 3% ofthe employee’s contribution, and will match at 50% the next 2% of the employee’s contribution. Please mail all enrollment forms back to Meredith Conner at the following address: Addison Search, LLC 222 S Riverside Plaza Suite 1710 Chicago, IL 60606 222 S. Riverside Plaza Ste 1710 Chicago, IL 60606 11 Phone: 312-425-0200 - Fax: 312-425-0210