Career Test – Stepped Version

Header Comment

Title Statement

Date

Name

Phone Number

Age

Are you 18 years or older?

Permanent Address

Position Desired

Preferred Start Date

Employment Status

Are you currently employed?

Inquiry

May we inquire with your present employer?

Availability

High School Name & Location

High School Degree / Certificate & GPA

College Names & Locations

College Degrees / Certificates & GPAs

Trade School Names & Locations

Trade School Degrees / Certificates & GPAs

Other School Names & Locations

Other Degrees / Certificates & GPAs

Employment 1 Name

Employment 1 Date

Employment 1 Position

Employment 1 Salary

Employment 2 Name

Employment 2 Date

Employment 2 Position

Employment 2 Salary

Employment 3 Name

Employment 3 Date

Employment 3 Position

Employment 3 Salary

Employment 4 Name

Employment 4 Date

Employment 4 Position

Employment 4 Salary

Did you work for any of these employers under a different name?

If yes, which employer and under what name?

Military Service

Served in the military

Branch

Honorably Discharged

Were you honorably discharged?

If no, please explain

Please explain any gaps in your employment history

Have you received any wrriten reprimands or disciplinary suspension during any previous employment?

If yes, please explain

Driver's License

Do you have a valid driver's license?

What class of license?

Driver's License Number

Have you ever had your license or driving privileges revoked, suspended, or placed on probation?

If yes, please explain

How many speeding or other moving violations have your received in the last three (3) years?

List all traffic violations on your record for the last five (5) years and all motor vehicle accidents

1st Reference Name

1st Reference Address

1st Reference Business

1st Reference Years Aquainted

2nd Reference Name

2nd Reference Address

2nd Reference Business

2nd Reference Years Acquainted

3rd Reference Name

3rd Reference Address

3rd Reference Business

3rd Reference Years Acquainted

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Facility Automation Solutions

6900 Phillips Industrial Blvd.
Jacksonville, FL 32256

Let's Talk

Phone: 904.446.8100
Fax: 904.446.8136

E-mail Us

info@facilityautomationsolutions.com

24 Hour Service

Phone: 904.446.8100