Marge Fox Personnel Services - temporary and permanent placement firm

The closest to perfection a person ever comes
is when they fill out a job application.

- Ken Kraft

APPLICANTS

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**Personal Information**
**(Use the TAB key or MOUSE to move between all entries)**

Name
Address
City, State Zip
Telephone
Fax
Cell
E-mail Address

Objective

Desired Work: (check all that apply)
Temporary/Contractual
Temp-to-Perm
Permanent

Desired Positions: (check all that apply)
Office Support Services:
Accounting Support Services:
Information Support Services:

Other

**Education**
**(Please show highest degree earned and current enrollment)**
	School 1
School Name
Address
City, State Zip
Major
Degree Received
Date Received

	School 2 (if applicable, otherwise go to Work History)
School Name
Address
City, State Zip
Major
Degree Received
Date Received

	School 3 (if applicable, otherwise go to Work History)
School Name
Address
City, State Zip
Major
Degree Received
Date Received

	School 4 (if applicable, otherwise go to Work History)
School Name
Address
City, State Zip
Major
Degree Received
Date Received

**Work History**
**Account for the past 10 years** **(List most recent employer first)**
	Employer 1
Company Name
Address
City, State Zip
Brief Description of Company
Size (# of employees)
Employment Start Date
Employment End Date
Supervisor
Phone
Ext.
Salary/Wage (i.e.: 28000 or 13.46)
Your Job Title
Description of duties
Reason for leaving

	Employer 2 (if applicable, otherwise go to Additional Information)
Company Name
Address
City, State Zip
Brief Description of Company
Size (# of employees)
Employment Start Date
Employment End Date
Supervisor
Phone
Ext.
Salary/Wage (i.e.: 28000 or 13.46)
Your Job Title
Description of duties
Reason for leaving

	Employer 3 (if applicable, otherwise go to Additional Information)
Company Name
Address
City, State Zip
Brief Description of Company
Size (# of employees)
Employment Start Date
Employment End Date
Supervisor
Phone
Ext.
Salary/Wage (i.e.: 28000 or 13.46)
Your Job Title
Description of duties
Reason for leaving

	Employer 4 (if applicable, otherwise go to Additional Information)
Company Name
Address
City, State Zip
Brief Description of Company
Size (# of employees)
Employment Start Date
Employment End Date
Supervisor
Phone
Ext.
Salary/Wage (i.e.: 28000 or 13.46)
Job Title
Description of duties
Reason for leaving

	Employer 5 (if applicable, otherwise go to Additional Information)
Company Name
Address
City, State Zip
Brief Description of Company
Size (# of employees)
Employment Start Date
Employment End Date
Supervisor
Phone
Ext.
Salary/Wage (i.e.: 28000 or 13.46)
Your Job Title
Description of duties
Reason for leaving

Additional Information

List Software Skill Experience (type "NONE" if not applicable)

Describe Specialized Skills, Training and Experience (type "NONE" if not applicable)

State Any Additional Information You Feel Would Be Helpful (type "NONE" if not applicable)

Languages - Describe Proficiency level; i.e. Fluent, Conversational, etc. (type "NONE" if not applicable)

REQUIREMENT FOR TRUTHFUL INFORMATION STATEMENT

I certify that all the information submitted on this application is true and complete, and I understand that if any false information, omissions or misrepresentations are discovered, my application may be rejected and, if I am employed, I may be subject to discipline up to and including discharge.

To certify, type your full legal name here:

Signature

Marge Fox Personnel Services, Inc. is an Equal Opportunity Employer. It is the company’s policy to make all employment decisions without regard to age, race, creed, color, religion, national origin, sex, disability, veteran status, marital status, or any other protected status in accordance with applicable federal, state or local laws.