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In order that your application may be properly evaluated, it is essential that all of the following questions be answered carefully and
completely, and that the Agreement on the last page of this application is signed and dated.
PERSONAL PROFILE/Full Time Applicants
Name LastFirstMiddle / Home Telephone No.() - / Social Security No.
- -
Address StreetCityStateZip / Work Telephone No.
() - / Message Phone
() -
Today’s Date
Month Day, Year / Cell Phone
() - / Email Address
@
Position Desired / What are the two most important factors to you in choosing a job? / Salary Expectations:
1. / 2.
Work Schedule Desiredfull time
part time
temporary / When can you start employment?
Date: // / Can you work a flexible schedule?
Please SelectYesNo
EDUCATION
High School / Name of School / Location / Graduated?Please SelectYesNo
College / Name of School / Location / Graduated?
Please SelectYesNo / Major course of study
Degree (if applicable)
Education and Training
Do you have an advanced degree or any other kind of education/training?
Please SelectYesNo / If “yes” please describe:
Training
1.
2.
3.
4.
5. / years completed
Licenses
Do you have any professional licenses, professional memberships or certifications?
Please SelectYesNo / If “yes” please describe:
1.
2.
3.
4.
EMPLOYMENT HISTORY
How many different employers have you worked for in the past 5 years? / Have you ever been previously employed by HHG?Please SelectYesNoIf yes, name at that time
Location Date of employment mm/dd/yyyy
EMPLOYMENT RECORD
Please account for the past five (5) years or since completing school, whichever is shorter, including military service or any self-employed or unemployed periods. Massachusetts applicants may include any verifiable work performed on a volunteer basis. Give all information requested
below even if duplicated on your resume. If your earnings on previous jobs were on a commission or other basis, estimate them on an annual
basis. Start with your present position and proceed chronologically backward. If required, use a separate piece of paper.
StateZip / Address Street CityStateZip /
Last Position Held
Telephone No.() - /
Dates Employed
mm/yy to mm/yy / Job DescriptionLast Supervisor’s Name / Be specific: Why did you leave? Or why do you want to leave?
Be specific: Liked most about the job: / Be specific: Liked least about the job:
Company
StateZip / Address Street CityStateZip /
Last Position Held
Telephone No.() - /
Dates Employed
mm/yy to mm/yy / Job DescriptionLast Supervisor’s Name / Be specific: Why did you leave?
Be specific: Liked most about the job: / Be specific: Liked least about the job:
Company
StateZip / Address Street CityStateZip /
Last Position Held
Telephone No.() - /
Dates Employed
mm/yy to mm/yy / Job DescriptionLast Supervisor’s Name / Be specific: Why did you leave?
Be specific: Liked most about the job: / Be specific: Liked least about the job:
OTHER INFORMATION
Are you legally eligible to work in the United States?Please SelectYesNoDocument Number (if applicable)
Can you perform the essential functions of the job with or without reasonable accommodation?Please SelectYesNo
PROFESSIONAL REFERENCES (Do not list relatives)
Name
/Address
/Phone
/Occupation
() -() -
() -
Do you have any relatives employed by HHG? Please SelectYesNo
If “yes”: NameLocation:Relationship:
REFERRAL INFORMATION
How were you referred to HHG? / Please SelectNewspaperInternetEmployee ReferralOtherIf “Other,” please explain:REPRESENTATIONS, UNDERSTANDINGS AND AGREEMENTS OF APPLICANT:
The facts set forth in my application for employment and in any resume or other documents provided for consideration in the application process are true and complete, without consequential omissions of any kind whatsoever. I understand that falsity of statements, answers or omissions made by me in this application, in any other document provided for consideration in the application process and in any interview may result in immediate dismissal.
I authorize Hudson Highland Group, Inc. (hereafter “HHG”) or client of HHG to contact my current employer before my current employment there ends.
Please SelectYesNo
I hereby give HHG or client of HHG the right to make a thorough investigation of my past employment, education, and activities, including investigative consumer and/or credit reports and credit and criminal records checks, and I release from all liability all persons and entities supplying such information. I indemnify HHG or client of HHG against any liability which might result from making such investigation. I release HHG and its officers, directors, employees and affiliates or client of HHG from any and all liability for damages of whatever kind which may arise from or relate to any “consumer report” and/or “investigative consumer report” or other background information requested, obtained or used by HHG or client of HHG. I authorize the persons, or entities named on this application form to give any information regarding me, whether or not it is in their records.
I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between HHG or client of HHG and myself, for either employment or for the providing of any benefit. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon HHG or client of HHG unless made in writing.
If accepted by HHG for employment, I hereby agree to abide by the directions, rules and policies of my employer whether or not in writing as they may be changed from time to time without notice. I agree that only written representations and promises signed by both myself and an officer of HHG will be enforceable and I understand that my employment is terminable at will by either party. I understand that no supervisor at HHG has the authority to change this employment at will status.
If I am offered employment with HHG, prior to or at the time I start work, I will be required to present one or more original documents establishing both my identity and my authorization to work in the United States. I also must verify my identity and my authorization to work on the I-9 Form required by the United States Immigration and Naturalization Service. Photocopies of the I-9 Form and the documentation that establishes my identity and work authorization will be provided by HHG only to persons who have a legitimate interest in this information for purposes of complying with the Immigration Reform and Control Act of 1986.
I understand that nothing in this document is intended to indicate that an offer of employment has been or will be made, it being understood that HHG or client of HHG will determine in its sole absolute discretion whether to make or not make any offer. I have read, understand and agree to the foregoing Representations, Understandings and Agreements and sign the same as my own free act.
______
Signature of ApplicantDate
This application is for Massachusetts and Philadelphia, PA applicants only