Tell us a little about yourself...

Date
Date
Name *
Name
Address *
Address
Phone
Phone
Please tell us what days you are available for work. Also please note any scheduling conflicts such as weekends or evenings that you wouldn't be able to work.
Are you a United States citizen? *
If no, are you authorized to work in the U.S? *
Are you a veteran or active military of the United States of America? *
Have you ever worked with us in the past? *
Have you ever been convicted of a felony? *
EDUCATION
High School Diploma or GED
Degree Level
REFERENCES (List 3)
Name *
Name
Phone *
Phone
Name *
Name
Phone *
Phone
Name *
Name
Phone 3 *
Phone 3
Employment History
Address 1 *
Address 1
Phone *
Phone
May we contact this person for a reference?
Address 2 *
Address 2
Phone *
Phone
May we contact this person for a reference?
Address 3 *
Address 3
Phone *
Phone
May we contact this person for a reference?
Address 4
Address 4
Phone
Phone
May we contact this person for a reference?
Read, Sign and Date *
I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired. I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, education and qualifications for employment. I also authorize you to request and receive such information. In consideration for my employment, I agree to abide by the rules and regulations of J&Z Professional Services,LLC, which rules may be changed, withdrawn, added or interpreted at any time, at the company’s sole option and without prior notice to me. I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of J&Z Professional Services, LLC.