Fill out this E-Application and we will contact you about the job opportunity or type of job opportunities you are interested in.
Category:
Choose a Category
Sales Representatives
Assembly/Production/Manufacturing
General Labor/Construction
Engineering
Administrative/Clerical
Accounting/Finance
Information Technology
Medical
Other
Location:
Choose a Location
Battle Creek
Grand Rapids
Hillsdale
Jackson
Kalamazoo
Lansing
Mt. Pleasant
Three Rivers
Other
Type:
Choose a Type
All Types
Short Term
Long Term
Trial Hire
Professional
Placement incl. Contract Jobs
Professional
Placement excl. Contract Jobs
Other
First Name:
Middle Name:
Last Name:
Suffix: (Jr., Sr., etc.)
Other Name: (Maiden, Married)
Nickname:
Street Address:
City:
State:
Zip Code:
Lived Here Since:
Year
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
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1956
1955
1954
1953
1952
1951
1950
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1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
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1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
Phone:
Pager:
Other Phone:
Email:
Social Sec. #:
Birthday:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
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21
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26
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28
29
30
31
How did you hear about us?:
Choose One
Newspaper
Radio
Internet
Yellow Pages
White Pages
Friend
General Referral
Minimum Pay Rate:
$
per
Period
Hour
Week
Month
Year
When are you available to work?:
Dates available to work:
Areas of Town?:
Do you have reliable transportation?:
Yes, No
EDUCATION - HIGH SCHOOL:
School Name:
School City, State:
GPA:
Graduated?:
Yes, No, Not Yet
EDUCATION - COLLEGE:
School Name:
School City, State:
GPA:
Graduated?:
Yes, No, Not Yet
Major:
Minor:
Diploma/Degree:
EDUCATION - GRADUATE/PROFESSIONAL:
School Name:
School City, State:
GPA:
Graduated?:
Yes, No, Not Yet
Diploma/Degree:
EDUCATION - OTHER:
School Name:
School City, State:
GPA:
Graduated?:
Yes, No, Not Yet
Diploma/Degree:
EMPLOYMENT HISTORY:
Start with your present or most recent. Include any job-related military service assignments and volunteer activities.
Employer #1:
City:
State:
Phone:
Supervisor:
Supervisor Title:
Shift:
Emp. From:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Emp. To:
Month
Present
January
February
March
April
May
June
July
August
September
October
November
December
Year
Present
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Starting Pay:
$
per
Period
Hour
Week
Month
Year
Final Pay:
$
per
Period
Hour
Week
Month
Year
Job Title:
Duties:
Still Employed Here?:
Yes (If No, complete below:)
Reason For Leaving:
Employer #2:
City:
State:
Phone:
Supervisor:
Supervisor Title:
Shift:
Emp. From:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Emp. To:
Month
Present
January
February
March
April
May
June
July
August
September
October
November
December
Year
Present
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Starting Pay:
$
per
Period
Hour
Week
Month
Year
Final Pay:
$
per
Period
Hour
Week
Month
Year
Job Title:
Duties:
Still Employed Here?:
Yes (If No, complete below:)
Reason For Leaving:
Employer #3:
City:
State:
Phone:
Supervisor:
Supervisor Title:
Shift:
Emp. From:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Emp. To:
Month
Present
January
February
March
April
May
June
July
August
September
October
November
December
Year
Present
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
Starting Pay:
$
per
Period
Hour
Week
Month
Year
Final Pay:
$
per
Period
Hour
Week
Month
Year
Job Title:
Duties:
Still Employed Here?:
Yes (If No, complete below:)
Reason For Leaving:
PLEASE LIST THREE REFERENCES:
Reference #1:
Title:
Phone:
Reference #2:
Title:
Phone:
Reference #3:
Title:
Phone:
Have you ever applied at an ADVANCE Office?:
Yes, No
If Yes, Where?:
If Yes, When?:
Have you ever been employed at an ADVANCE Office?:
Yes, No
If Yes, Where?:
If Yes, When?:
Have you ever been granted a security clearance?:
Yes, No
Have you ever been bonded?:
Yes, No
Have you ever been convicted of a crime since the age of 18?:
Yes, No
Or, have you been convicted of a crime and tried as an adult if younger than 18?:
Yes, No
If Yes for either criminal conviction, explain:
CRIMINAL RECORD CHECKS WILL BE PERFORMED
REFERENCE CHECK RELEASE
I hereby request and authorize any and all of my past or present employers, educational institutions, business associates, and government bodies to release any and all documents, records, and other information relating to my backgrounds and qualifications for present or future employment with ADVANCE Employment or its authorized agents and representatives. I understand that all information obtained will be held in confidence and I acknowledge that a copy or facsimile of this document carries the same validity as the original.
I hereby release and discharge ADVANCE, its officers, directors, employees, agents, and representatives and any person or entity so providing information from any and all liability of every nature and kind arising from the furnishing od such documents, records, and other information.
The entering of the Name, Social Security Number, and Date information below will constitute a legal Electronic Signature.
Full Name:
Other Names:
Social Sec. #:
Date:
I hereby declare that all statements contained in this application and given orally are true and correct and understand that false or inaccurate information in the application will be the basis for termination.
I will hold harmless, indemnify, and defend ADVANCE Employment from all claims and loss including but not limited to personal illness and injury resulting from supplying false or misleading information.
I hereby authorize ADVANCE Employment to investigate my background, including a criminal records check, and verify this information.
I also authorize ADVANCE Employment to release the information contained herein and its findings and work history of my employment to other firms or persons upon request.
I understand and agree:
that if employed, my employment will not be for any fixed period of time and may be terminated by ADVANCE Employment at any time without liability except for wages earned;
that the term of my employment with ADVANCE shall be limited to the duration of any temporary assignments hereunder and my employment is "at will";
that I may be expected to work on a wide variety of job assignments in the service area of this office and agree to accept assignments for which I am qualified as they become available;
that my failure to report to an assignment for work will indicate I have quit;
to submit to a drug screen upon request or as specified in ADVANCE Employment's substance abuse policy;
not to publish, disclose, or utilize any confidential information of your company or your clients where you send me to work and I will assign and disclose to your client any invention perfected or conceived during my hours of work for such client and will sign all papers necessary to enable your client to patent these inventions and to obtain copyrights;
that I will not solicit nor accept any work with the clients of ADVANCE Employment without prior written notice to ADVANCE;
that I have received and read ADVANCE Employment's Personnel Policies and agree to follow them.
The entering of the Name and Date information below will constitute a legal Electronic Signature.
Full Name:
Date: