Application : Powered by PRO Resources

PERSONAL INFORMATION

	Date Of Application (required)	Year
	First Name (required)
	Last Name (required)

	Current (required) Address	Street Address City State Zip

	Previous Address 1	Street Address City State Zip

	Previous Address 2	Street Address City State Zip

	Phone Number (including area code)
	Email Address

Are You
A United States
Citizen?

Yes

If Hired, Can You Furnish Proof That You Are Legally Permitted To Work In The U.S.?

Yes

Are You Under The Age Of 18?

Yes

Referred By:

Friend

Walk-in

Relative

Employment Agency


In Case Of Emergency Notify:	Contat Name Relationship
	Home Phone (include area code)
	Work Phone (include area code)
EMPLOYMENT DESIRED
Position		Date You Can Start Year	Salary Desired per/hr
Are You Employed Now? Yes No	If So, May we contact present employer? Yes No

Type Of Employment You Are Seeking Full-Time Part-Time Temporary —From to

EDUCATION

Name And Location
Of School

The Last Year
Completed

Did You
Graduate

High School

1
2
3
4

Yes

Trade, Business Or
Correspondence School

1
2
3
4

Yes

College

1
2
3
4

Yes

What Business Machines Can You Operate?	Calculator/ Adding Machine	Cash Register	Computer	How Many Words Per/Minute Can You Type?

Special Skills Or Experience?

What Foreign Languages Do You Speak Fluently?

FORMER EMPLOYERS (List Last Three Employers, Starting With The Last One First)
EMPLOYER (required)
Name		Start Date Year
Address Street City State Zip		End Date Year
		Position/Job Title
		Last Pay Rate
Phone (including area code)		Reason For Leaving
Immediate Supervisor

EMPLOYER (required)
Name		Start Date Year
Address Street City State Zip		End Date Year
		Position/Job Title
		Last Pay Rate
Phone (including area code)		Reason For Leaving
Immediate Supervisor

EMPLOYER (required)
Name		Start Date Year
Address Street City State Zip		End Date Year
		Position/Job Title
		Last Pay Rate
Phone (including area code)		Reason For Leaving
Immediate Supervisor

REFERENCES
(Give The Name Of Three Persons Not Related To You, Whom You Have Known At Least One Year)

Name

Address

Business

Telephone
(including area code)

Street

City

State

Zip

PHYSICAL RECORD

Are you able to perform the essential functions of the job?	Yes No

What other qualifications should be considered?

This application was completed by me, all entries upon it and information in it are true and complete to the best of my knowledge. Any false or misleading information furnished by me on this application or other required documents or in connection with my application shall result in denial of employment or, if employed by PRO Resources Corporation, the termination of my employment. PRO Resources Corporation has my consent to make a thorough investigation on my background, including my past employment, references furnished, education and any other activities, and I release all persons, firms or entities supplying such information from any and all liability and damages on account of supplying such information. I further agree to indemnify PRO Resources Corporation against any and all liability that may result from making such an investigation. I also acknowledge and understand that I am applying for employment with PRO Resources Corporation, that if hired I will be an employee of PRO Resources Corporation, and that I can be terminated at any time with or without cause. I understand and agree that if I am employed by PRO Resources Corporation, as a condition of my employment with PRO Resources Corporation, PRO Resources Corporation has the right to transfer my services to any available position, therefore, I agree to accept a position that I am qualified to perform. In the event that training may be needed, I agree to participate in any training that may be necessary to satisfy the position. I further agree that I will abide by all the rules, regulations and policies of PRO Resources Corporation and that failure to do so may be cause for termination. I further agree that in the event I am advanced any money by PRO Resources Corporation or any of its subscribers, and fail to make payment as agreed,
PRO Resources Corporation may deduct the amount unpaid from any wage I may have coming.

Electronic Signature*: (First and Last name required)

Email:

Date*: year (required)

Your ip address will be used as an additional personal identifier. Typing your name in the Electronic Signature box above is legally binding under the Uniform Electronic Transactions Act (UETA). Please check this box to show that you have read and agreed to this statement.(required)