Tier 1 Employee Application - San Antonio
Page 1
Last Name:
First Name:
Middle Name:
Mailing Address:
City:
State:
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
Primary Contact #:
Secondary Contact #:
E-mail:
Highest level of education completed:
Please select...
Did Not Graduate
High School Graduate/GED
Vocational School
Some College (currently attending)
College Graduate (Bachelors)
Masters
Doctorate
High School:
Year Graduated:
College/Vocational:
Year Graduated:
Degree:
GPA:
Masters:
Year Graduated:
Degree:
GPA:
Doctorate:
Year Graduated:
Degree:
GPA:
Have you served in the United States Military?
Yes
No
Branch:
Please select...
Army
Navy
Marine Corps
Air Force
Coast Guard
Army National Guard
Air National Guard
From:
Please select...
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
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1932
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1951
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1967
1968
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1972
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1976
1977
1978
1979
1980
1981
1982
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1984
1985
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1987
1988
1989
1990
1991
1992
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1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
To:
Please select...
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
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1930
1931
1932
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1935
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1939
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1941
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1943
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1945
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1951
1952
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1954
1955
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1957
1958
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1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Separation Rank:
Are you now in the Military Reserve or National Guard?
Yes
No
Branch:
Please select...
Army Reserve
Navy Reserve
Marine Corps Reserve
Air Force Reserve
Coast Guard Reserve
Army National Guard
Air National Guard
Have you ever been convicted of a felony?
Yes
No
How Many?
Please select...
1
2
3
4
5+
Year:
Please select...
2016
2015
2014
2013
2012
2011
2010
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
1907
1906
1905
1904
1903
1902
1901
1900
Offense Details:
Year:
Please select...
2016
2015
2014
2013
2012
2011
2010
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
1907
1906
1905
1904
1903
1902
1901
1900
Offense Details:
Year:
Please select...
2016
2015
2014
2013
2012
2011
2010
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
1907
1906
1905
1904
1903
1902
1901
1900
Offense Details:
Year:
Please select...
2016
2015
2014
2013
2012
2011
2010
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
1907
1906
1905
1904
1903
1902
1901
1900
Offense Details:
Year:
Please select...
2016
2015
2014
2013
2012
2011
2010
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
1907
1906
1905
1904
1903
1902
1901
1900
Offense Details:
How did you hear about Tier 1 Personnel?
Please select...
Advertisement
Customer Referral
Friend
Internet - Craigslist
Internet - Indeed
Internet - Other
Other
Customer Name:
Other:
Have you ever worked with a staffing agency before?
Yes
No
Which ones?
Page 2
Employment Information
What type of position are you seeking?
Office/Admin/Clerical
Labor/Skilled Trades/Industrial
Office Specific Titles/Positions Seeking:
Industrial Specific Titles/Positions Seeking:
Are you currently working right now?
Yes
No
How much notice will you have to give?
Please select...
No notice
Less than 1 week
1-2 weeks
2+ weeks
Will you work as a temporary?
Yes
No
What days of the week can you work?
Sun
Mon
Tue
Wed
Thu
Fri
Sat
What shifts can you work?
1st Shift
2nd Shift
3rd Shift
12-Hour
Part-Time
Full Time
1st: Morning-Afternoon 2nd: Afternoon-Evening 3rd: Evening-Morning
What areas of town are you willing to work in?
North
South
East
West
Central
1st: Morning-Afternoon 2nd: Afternoon-Evening 3rd: Evening-Morning
How many miles are you willing to travel?
Please select...
Less than 10
10-20
20-30
30+
Do you have reliable transportation?
Yes
No
Do you have a valid Driver's License?
Yes
No
State:
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Type:
Please select...
Class A
Class B
Class C
Operator
Minimum Hourly Pay Rate:
Are you bilingual?
Yes
No
Language:
Please select...
Spanish
Arabic
French
German
Hindi
Mandarin
Portuguese
Russian
Labor/Skilled Trade/Industrial
Skills (Select all that apply)
Electronics
Assembly
Circuit/PC Board
Color Codes
Repairs
Quality Control
Schematics
Soldering
Troubleshooting
Skilled Labor
Brake/Shear
Carpenter
Certified Electrician
Certified HVAC
Cherry Picker
Concrete
Construction
Drill Press
Drywall Finishing/Hanging
Forklift (sit-down)
Forklift (stand-up)
General Repair
Grinder - Sand/Grit/Hyrdo
Heat Treat
Heavy Equipment Operator
Heavy Equipment Repair
Hydraulics
Industrial Painter
Maintenance
Measuring Tools
Metric Scale
Metric System
Overhead Crane
Perform Setups
Plastic Molding
Plumber
Pneumatics
Printing
Punch Press
Read Blueprints
Setups
Tool Die
Truck Mechanic
Food Service
Banquet Service
Catering
Dietary
Food Preparation
Greeter
Welding
Code
Fitter-Welder
Fluxcore
Heliarc
Arc/TIG/MIG
Pipe
Plate
Stick
Subarc
Structural
Sheet Metal
General
Labor
Assembly Line
Grounds/Yard Work
Housekeeping
Janitor
Landscaping
Material Handling
Mechanical Assembly
Shipping/Receiving
Inventory
Warehouse
Machinist
CNC Lathe
CNC Mill
Programs
Engine Lathe
Manual Mill
Press
Ovens
Burners
Other/Specific Skills and/or Machinery
Certifications/Licenses:
What PPE do you own?
None
Steel-toe Boots
Safety Glasses
Gloves
Vest
Hard Hat
Back Support
Other
Personal Protective Equipment
Other:
Clerical/Admin/In-Office
Skills (Select all that apply)
Accounting
Accounts Payable
Accounts Receivable
Bookkeeper
Cashier
Collections
Payroll ADP
Payroll General
Payroll Under 50
Payroll Over 50
Taxes
Other Accounting
Computer
Android
Autocad
Desktop Publishing
Graphics
iOS
IT/Troubleshooting
MS Access
MS Excel
MS Front Page
MS Outlook
MS Publisher
MS Word
Pagemaker
Peachtree
PeopleSoft
Quickbooks
Windows 7/8/10
Other
Collections
1st Party
3rd Party
FDCPA Knowledge
Patient Accounts
General
Filing-Alpha
Filing-Numeric
Mailroom
Proofreading
Reception
Switchboard/Multi-Line
Telephone Etiquette
Telephone Skills
Industry
Specific
Advertising/PR
Aerospace
Airlines
Architectural
Banking/Svg. & Loan
Call Center
Computer/Data Processing
Communications
Construction
Education
Electronics
Finance
Freight
Government
Hotel-Motel
Insurance
Manufacturing
Marketing
Medical
Mortgage/Banking Loan
Oil & Gas
Personnel/Human Resources
Property Management
Publishing
Real Estate
Retail
Sales
Transportation
Utilities
Other
Copier
Keystrokes
Fax
Microfiche
Sales
Catalog
Customer Service
Inside
Outside
Retail
Route Sales
Survey
Telephone
Typing
Data Entry (WPM)
Legal Terminology
Medical Terminology-ICD9 Coding
Shorthand
Statistical Typist
Stenographer
Straight Copy
Typing (WPM)
Words Per Minute:
Other/Specific Skills:
Certifications/Licenses:
Page 3
Employment History:
Please enter employment history, starting with the most recent. Please be as detailed as possible.
Number of Previous Positions:
Please select...
1
2
3
4
5+
Employment #1
From:
To:
Employer Name:
City:
State:
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Title:
Salary:
Supervisor:
Phone #:
Duties:
Reason for Leaving:
Was this through a staffing agency?
Yes
No
Employment #2
From:
To:
Employer Name:
City:
State:
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Title:
Salary:
Supervisor:
Phone #:
Duties:
Reason for Leaving:
Was this through a staffing agency?
Yes
No
Employment #3
From:
To:
Employer Name:
City:
State:
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Title:
Salary:
Supervisor:
Phone #:
Duties:
Reason for Leaving:
Was this through a staffing agency?
Yes
No
Employment #4
From:
To:
Employer Name:
City:
State:
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Title:
Salary:
Supervisor:
Phone #:
Duties:
Reason for Leaving:
Was this through a staffing agency?
Yes
No
Employment #5
From:
To:
Employer Name:
City:
State:
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Title:
Salary:
Supervisor:
Phone #:
Duties:
Reason for Leaving:
Was this through a staffing agency?
Yes
No
Page 4
Screening
Do you agree to a drug screen if required for employment?
Yes
No
Do you agree to a criminal background check?
Yes
No
Tier 1 Personnel Employee Agreement
Agree
I understand that Tier 1 Personnel provides quality service as its primary goal and that I will contribute to that goal by representing myself and Tier 1 Personnel in a quality manner.
I understand that my employment relationship with Tier 1 Personnel is an employment at-will relationship and upon notice by employer or employee can be terminated effective immediately with or without notice or explanation provided.
I understand that I am to call Tier 1 Personnel and make them aware of my availability within 25 hours of completion of assignment. If I do not call to inform Tier 1 Personnel of my availability, please assume that I am not available to work.
If offered a job or extended an offer of employment while on assignment with Tier 1 Personnel, I will notify Tier 1 Personnel accordingly and provide a two-week notice.
I authorize and consent to every firm, person, company, corporation, school, or institution having control of any information, documents, records, etc., pertaining to me to supply such information for Tier 1 Personnel or its agents. Furthermore, I release and hold harmless Tier 1 Personnel and its agents from all liability.
I understand that Tier 1 Personnel has a commitment to maintain an Alcohol/Drug free workplace and I understand that my employment is contingent on the results of an Alcohol/Drug screen test. I understand that the purpose of this analysis is for pre-employment screening purposes and/or is determined to seek out the presence of non-prescribed or prohibited controlled substances or alcohol within my system and may be requested as a pre-employment test, continuation of employment, a form of routine testing, or as a result of an injury that has taken place while performing job duties, work-related accidents, unusual behavior, etc. I understand that by refusing such requests will disqualify me for employment, potential of employment, and/or consideration of employment.
Illegal use, impairment, or the sale or possession of narcotics and/or alcohol is strictly prohibited while on the property of Tier 1 Personnel or the company of which I have been assigned to work at. Any violation of these standards will result in the immediate termination of my employment.
I understand that Tier 1 Personnel retains the right to alter or modify any policies at any time without advance notice. I further understand that any false, inaccurate, or omitted information provided to Tier 1 Personnel as part of the hiring process is grounds for immediate termination, no matter when such is discovered.
I understand Tier 1 Personnel is committed to equal opportunity employment opportunity regardless of the race, sex, color, religion, age, national origin, or disability of any applicant or employee.
I understand that while on assignment with Tier 1 Personnel, its clients and/or vendors, all confidential information will remain as such and will not be disclosed or discussed.
I will not solicit or accept employment with any client of Tier 1 Personnel without prior written agreement and/or consent of Tier 1 Personnel
I understand that my hourly pay can and/or may be reduced to State Minimum Wage for any/all hours work and/or completed if I abandon my assignment prematurely or prior to completion as scheduled and agreed by myself and Tier 1 Personnel. This includes voluntary resignation without notice, no call/no show, or walk off action.
I understand that it is the policy of Tier 1 Personnel that all employees that are terminated or separated from an assignment for any reason, what so ever, with or without notice or explanation, whether voluntary or involuntary, have no contact with clients of Tier 1 Personnel, its contracted vendors, suppliers, customers, or subsidiaries.
Upon completion of application, I understand that my signature will serve as acceptance and complete understanding of the above stated. Failure to sign this acknowledgement will result in immediate termination of my relationship with Tier 1 Personnel and will no longer be considered for or eligible for placement for employment.
By typing your full name, you agree that all the information provided in this application is true and correct to the best of your knowledge, and you agree to abide by Tier 1 Personnel's Employee Agreement.
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