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Legal First Name

Middle Name

Last Name

SSN

Position Desired

DOB

Salary Desired

Street Address

Phone Number

Email

Emergency Contact Name & Phone Number

Date Available

Zip

City

State

Marital status

If required, are you willing and able to lift 10, 20 ,30, 45-50 lbs.

How often are you able to lift that amount

What Days are you willing to work (Mon-Sun)

Are you legally eligible for employment in the U.S?

YesNo

Did you Graduate from High School

Diploma or GEDNone

College Degree

Are you 18 years of age or older

YesNo

How did you learn about Unify Staffing? Indeed, LinkedIn, Social Media, Friend, Employee or Drive by

Do you have reliable transportation

YesNo

As a condition of employment, will you submit to a drug test for use of illegal drugs

Yesno

Are there any reasons you cannot perform the functions of the job for which you are applying for, with or without reasonable accommodations?

YesNo

Are You Currently Employed

YesNo

Are You Willing To Work Overtime

Yes No

Available to work Weekends?

Yes No

Available to work any shift?

Military Service: have you obtained any special skills as result of service in the Military

Yes No

Have you Received Covid-19 Vaccinations

YesNo

Have you been in contact with anyone longer than 15 minutes in close proximity that has tested positive for Covid-19

YesNo

Have you had any of the following symptoms in the last 15 days ( cough, shortness of breath, fever/chills, headache, sore throat, or loss of taste and smell.

YesNo

Have you filed for unemployment in the last 27 weeks?

Unify Staffing is an equal opportunity employer. Please check Yes that you acknowledge that you have provided true and correct information

YesNo

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Standard Employee POSITION IN San Dimas, CA

Personal Information

Standard Employee POSITION IN San Dimas, CA

Employment Information

Standard Employee POSITION IN San Dimas, CA

Skills Information

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