American Staffing, Inc.

731-313-7000
382 A&B Carriage House Dr. Jackson TN 38305

American Staffing, Inc. is an Equal Opportunity Employer

Personal Information

(Proof of Citizenship or eligibility is upon employment in keeping with the RCA)

Conviction of a crime will not automatically disqualify you from consideration for employment, but will be considered as part of an overall evaluation of your qualifications.


Employment Desired

Educational History

Elementary

High School

College

Other


General

Exclude organizations, the name of which indicates the race, creed, sex, age, marital status, color, or nation of origin of its members.


Factors such as race, religion, sex, national origin, age, or disabilities are not factors in employment decisions.

Employment History

List entire employment history, starting with your present employer. For any un-employed or self-employed periods, show dates and location. (Attach additional sheets if necessary.)

Company #1


Company #2


Company #3


Company #4


List two people (other than family members) you have worked with, that we may contact for a reference.


Certification of Information


Skills

Please open a menu and select a unit and enter a corresponding number

  • *CNC Machinist:

  • *Grinder:

  • *Lathe:

  • *Mill:

  • *Facing:

  • *Turning:

  • *Drill:

  • *Reaming:

  • *Boring:

  • *Surface Grinding:

  • *Structural:

  • *MIG:

  • *TIG:

  • *Stick:

  • *Flux Core:

  • *Combination:

  • *Rough-In:

  • *Finish:

  • *Cabinetry:

  • *Design:

  • *AutoCad/Blue Prints:

  • *Residential Electrician:

  • *Industrial Electrician:

  • *Design:

  • *AutoCad/Blue Prints:

  • *Pipe Fitter:

  • *Industrial Maintenance:

  • *Blueprints:

  • *Residential Plumber:

  • *Soldering:

  • *Commercial:

  • *Residential:

  • *Repair:

  • *Installation:

  • *Auto Mechanic:

  • *Industrial Mechanic:

  • *Diesel Mechanic:

  • *Crane:

  • *Trackhoe:

  • *Backhoe:

  • *Dozer:

  • *Grader:

  • *Pan:

  • *Frontend Loader:

  • *Pavement Roller:

  • *Dump Truck:

  • *Clerk:

  • *Receptionist:

  • *Multi-Line Phone:

  • *Switchboard:

  • *Secretary:

  • *Office Assistant:

  • *Accounts Payable:

  • *Accounts Receivable:

  • *Workers' Compensation:

  • *Inventory Clerk:

  • *Data Entry:

  • *Supply Clerk:

  • *Customer Service:

  • *Office Manager:

  • *Human Resource Assistant:

  • *Human Resource Manager:

  • *Book Keeping:

  • *Tax Computing:

  • *Faxing:

  • *Copying:

  • *10 Key:

  • *Typist:

  • *Intermediate Computer Skills:

  • *Advanced Computer Skills:

  • *Filing Clerk:

  • *Payroll:

  • *Advertising/Sales:

  • *Computer Tech:

  • *Front Desk Clerk:

  • *Microsoft Word:

  • *Microsoft Works:

  • *Microsoft Excel:

  • *Powerpoint:

  • *Access:

  • *Quick Books:

  • *Lotus:

  • *DOS:

  • *Windows Version:

  • *Internet:

  • *Construction:

  • *Clean-Up:

  • *General Labor:

  • *Farmer:

  • *Mason:

  • *Painter:

  • *Roofing:

  • *Steel Hanger:

  • *Tree Trimmer:

  • *Landscape:

  • *Lawn Maintenance:

  • *Insulation:

  • *Carpentry:

  • *Glass Cutting:

  • *Lumber Stacker:

  • *Flagger:

  • *Material Handler:

  • *Delivery Driver:

  • *CDL Driver Class:

  • *Hazmat:

  • *Tanker:

  • *Doubles:

  • *Strap Steel:

  • *Supervisor:

  • *Oil & Tire Changer:

  • *Auto Body:

  • *Auto Paint:

  • *Carpet Installer:

  • *Over Head Crane:

  • *Power Tools:

  • *Hand Tools:

  • *Radial Saw:

  • *Band Saw:

  • *Drill Press:

  • *Deburring:

  • *Shears:

  • *Forge:

  • *Machine Operator:

  • *Banding:

  • *Punch Press:

  • *Hydraulics:

  • *Used Micrometers:

  • *Used Calipers:

  • *Soldering:

  • *Cable Installer:

  • *Warehouse:

  • *Shipping/Receiving:

  • *Purchasing:

  • *Fork Lift:

  • *Side Lift:

  • *Scissor Lift:

  • *Packer Assembly:

  • *Plant Supervisor:

  • *Certified Nurse Aide:

  • *Licensed Practical Nurse:

  • *Registered Nurse:

  • *Cashier:

  • *Stocking:

  • *Cook:

  • *Prep:

  • *Maid Service:

  • *House Keeper:

  • *Janitorial:

  • *Telemarketing:

  • *Banking:

  • *Child Care:

  • *Dispatcher:


General Safety Rules

*I, , acknowledge I understand the rules and will abide by them. I understand that not following the rules listed above could result in disciplinary action up to and including termination of employment and/or eligibility for future employment with American Staffing, Inc.


Workman's Compensation Policies and Procedures

*I, , understand American Staffing, Inc. Workman's Compensation Policy and Procedures. By signing this document I acknowledge I understand the rules and will abide by them. I understand that not following the policy and procedures listed above could result in disciplinary action up to and including termination of employment or eligibility for future employment with American Staffing, Inc.


Reference Check Authorization

*I, , do hereby authorize any of my former employers listed on my application to release any and all information to American Staffing, Inc. pertaining to my employment.


Policy and Procedures Checklist

By signing this document I acknowledge that I understand the rules and will abide by them. I understand that not following the policies / procedures listed above could result in disciplinary action up to and including termination of employment and/or eligibility for future employment with American Staffing, Inc.


Drug Screen Authorization

I understand American Staffing, Inc. will require a pre-employment drug screen. Drug screens are paid for by American Staffing, Inc. However, if my drug screen should come back positive, or if I voluntarily quit, or if I am let go for cause within the first ninety (90) days, I will be expected to pay for the cost of the drug screen. The cost of the drug screen is Fifty ($50.00) dollars and will be deducted from my last paycheck.

Should my drug screen result be positive, I will be allowed to have the specimen sent to a medical laboratory at my own cost. If the drug screen was false positive, I may be eligible for hire.

I, , hereby authorize and give full permission to have American Staffing, Inc. and/or the medical facility of their choice to collect a urine specimen for screening for the presence of illegal drugs, alcohol, or prescription medication without a prescription.


Release of Criminal Records

In connection with my application for employment, I understand that an investigative consumer report may be requested that will include information about my character, work habits, performance, and experience, along with reasons for termination of past employment. I understand that as directed by company policy and consistent with the job described, you may be requesting information from public and private sources about my: workers' compensation injuries, driving record, court record, education, credentials, credit, references or other information deemed important by American Staffing, Inc. or any sister companies.

Medical and Workers' Compensation information will only be requested in compliance with the Federal Americans with Disability Act (ADA) and/or any other applicable state laws. I am entitled to know if employment is denied because of information obtained by my prospective employer from a consumer reporting agency. I understand that I may ask for and receive a copy of information obtained by my prospective employer from a consumer reporting agency including the name and address of the agency.

I, the undersigned, do hereby authorize, without reservation, any law enforcement agencies, institution, information services bureau, school, employer, reference, or insurance company contacted by American Staffing, Inc. or its agents, to furnish the information described above. I, the undersigned, do authorize American Staffing, Inc. and the company assigned to, to examine any and all criminal records on file in the counties of any state. In doing so, I understand that I am waiving my right of confidentiality concerning my criminal record.


Essential Job Functions

Please select yes or no for each statement. If you select no, this does not disqualify you from employment with American Staffing, Inc., it simply helps us to select the job assignment most appropriate for you.


I accept and approve the sharing of my personal identification data with employers who may be prospective employers.