Online Job Application

Position Applied For:
Referral Source: Employee Advertisement
Other
Name of Source:
Personal Information
First Name:
Middle Initial:
Last Name:
Nickname:
First name that you go by
E-Mail
Street:
City:
State:
Zip:
Telephone:
Best time to call:
Date available to work:
Minimum salary requirement:
General Information
Are you legally authorized to work in the United States?
Are you below the age of 18?
Yes No
Have you ever applied to or been employed by Taction?
Yes No
If Yes, please provide date(s):
Do you know of any reason why you cannot perform the essential functions of the job for which you are applying with or without reasonable accommodations?
Please review job description (here) before responding.
Type of employment desired: Temporary Educational Co-Op
Full-Time Part-Time
What is your shift preference? Daytime Evening Overnight
Are there any hours or days of the week when you are unavailable?
Yes No
If Yes, please explain:
In order to be fair with respect to the division of weekend work, employees are required to work one weekend shift per month However, after two years of employment, an employee may apply for a rotating weekend schedule.
What is your ideal weekend shift? Saturday: Day Evening
Sunday: Day Evening
Understanding that our shifts start nearly every hour of the day and evening, if you could create your own ideal shift, what might it be?
What is the earliest hour your are available to come to work?
What is the latest hour you are available to work?
What are the minimum hours you require per week?
What are the maximum hours you are able to work per week?
You must be available for occasional evening staff meetings. Will this be a problem?
Yes No
Have you been convicted of any crimes, not including minor traffic violations?
Yes No
If Yes, please explain, including the date and nature of the conviction or violation:
Note: A past conviction does not automatically disqualify you from consideration for employment
Education 1
School:
Name and address of school:
Check last year completed: 1 2 3 4
Area of study or degree received:
Education 2
School:
Name and address of school:
Check last year completed: 1 2 3 4
Area of study or degree received:
Employment History
List your last three (3) employers, assignments, or volunteer activities, starting with the most recent. Explain any gaps in employment in the comments section below.
Employer 1
Name:
Telephone:
Address:
Job title:
Supervisor and title:
Reason for leaving:
Are you eligible for re-hire? Yes No
May we contact for reference? Yes No Later
Dates employed:
Hourly rate: Starting: Final:
Summarize nature of work performed and job responsibilities:
Employer 2
Name:
Telephone:
Address:
Job title:
Supervisor and title:
Reason for leaving:
Are you eligible for re-hire? Yes No
May we contact for reference? Yes No Later
Dates employed:
Hourly rate: Starting: Final:
Summarize nature of work performed and job responsibilities:
Employer 3
Name:
Telephone:
Address:
Job title:
Supervisor and title:
Reason for leaving:
Are you eligible for re-hire? Yes No
May we contact for reference? Yes No Later
Dates employed:
Hourly rate: Starting: Final:
Summarize nature of work performed and job responsibilities:
Employment Comments
Comments (including explantion of any gaps in employment):
Skills and Qualifications
Summarize any special training, skills, licenses, certificates, and/or characteristics of yourself that may qualify you as being able to perform job-related functions for the position for which you are applying:

Please read the following information before signing application.

  1. I hereby certify that the information contained in the application is true and complete. Any false statements or omissions on this application may result in my immediate dismissal.
  2. I understand that if employed, I will be an "employee at will," and both Taction and I will have the right to terminate my employment at any time, with or without cause. I understand that no one has the authority to make any agreement or representation to the contrary.
  3. I authorize Taction to contact my previous employers and other references listed in this application. I authorize my previous employers and my references to give any information concerning my previous employment or other qualifications for the position for which I have applied.
  4. I understand that if employed, I will be required to furnish sufficient proof to satisfy government regulations regarding my eligibility for employment in the United States.
  5. I understand that this is not a contract for employment.

Please type your name into the box below to indicate your "signature."

Signature: