New Solutions Staffing - Employment Application

Last Name:	Middle Initial:		First Name:
E-mail:	Alternate E-mail:	Other E-mail:	Street Address:
City:	State:	Zip:	Country:
Home Phone: Acceptable Characters ( ) - + and space		Cellular Phone: Acceptable Characters ( ) - + and space	Fax: Acceptable Characters ( ) - + and space
Objective:		Summary:

REFERENCES

Name & Position:	Firm Name:	Title:
Telephone: Acceptable Characters ( ) - + and space	Mobile: Acceptable Characters ( ) - + and space	Email Address:
Relationship: Professional Personal

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I certify that the information given herein is true and complete to the best of my knowledge. I authorize to make such investigations and inquiries of the information provided herein, and other matters related hereto, as may be necessary. I hereby release employer, schools, and other persons, institutions or businesses from all liability in responding to inquiries in connection with my application. I understand that false or misleading information given in my application or during interviews may result in a refusal to hire, or discharge in the event of employment.

Security Code :

Are you willing to relocate? Yes No
City:	State:	Country:
Type of Employment: Direct Temp/Contract Internship
Preferred Hours: Full Time Part Time	Salary Desired:
Location: On-Site Off-Site No Preference	Availability: Immediate