SkilCheck Services

Personal Information

A description of the section goes here.
Name *
Prefix
First *
Last *
Suffix
Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Phone Number *

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Alternate Phone Number

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Email
Are any of your relatives / friends currently employed with us or have any worked for us in the past? *
 Yes 
 No 
If yes, name of your relative / friend:
Are you eligible to work in the United States? *
 Yes 
 No 
If you are under age 18, can you provide required ID to work? *
 Yes 
 No 
 I am over 18 
How were you referred? *
Have you ever been convicted of a crime? *
 Yes 
 No 
If yes, when? For what offense?
Have you ever worked for any of our companies or divisions? *
 Yes 
 No 
If yes, which facility / office?

POSITION/AVAILABILITY:

A description of the section goes here.
Position Applied For *
Do you speak fluent Spanish? (not a requirement but we need Spanish speaking callers from time to time) *
 Yes 
 No 
Days Available *
 Monday 
 Tuesday 
 Wednesday 
 Thursday 
 Friday 
 Saturday 
 Sunday 
 Any 
Hours Available *
 AM 
 PM 
 Any 
What date are you available to start work? *

MM
/
DD
/
YYYY
If our mystery caller position is filled for the month you are applying in, would you like to be considered for future months? *
 Yes 
 No 

EDUCATION:

A description of the section goes here.
High School *
Graduated high school? *
 Currently Attending 
 Yes 
 No 
College / Trade School
Graduated college / trade school? *
 Currently Attending 
 Yes 
 No 
 N/A 
Skills *
 I am personable on the phone 
 I can use a Windows operating system 
 I can use a keyboard 
 I can use a telephone 

EMPLOYMENT HISTORY:

Present Or Last Position:
Employer: *
Address: *
Supervisor: *
Phone Number *

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Email
Position Title: *
Start Date *

MM
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DD
/
YYYY
End Date *

MM
/
DD
/
YYYY
Responsibilities: *
Salary *
Input hourly wage, if not salaried.
Reason for Leaving: *
May We Contact Your Present Employer?
 Yes 
 No 

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