Achieve Employment Solutions

Online Application for Light Industrial

Please take a moment to fill out this application to the best of your abilities.

How did you hear about us? *

First Name *

Middle Initial

Last Name *

Street Address *

Apartment or Building

City *

State *

Zip *

Personal Email

Work Email

Home Phone

Cell Phone

Work Phone

Emergency Contact

Emergency Phone

Have you ever used another name?	yes no

Is any additional information relative to change of name, use of an assumed name, or nickname necessary to enable a check on your work and education record? If Yes, please explain:

Date Available

Preferred Job Type

Minimum compensation requirement per hour for temporary positions

Minimum annual salary requirement for direct hire positions

High School Name

High School City

High School State

High School Status

College Name

College City

College State

College Major

Degree/Certifications

College Status

Second College Name

Second College City

Second College State

Second College Major

Second College Degree/Certifications

Second College Status

Graduate School Name

Graduate School City

Graduate School State

Graduate School Major

Graduate College Degrees/Certificates

Graduate School Status

Clerical Skills	None 10 Key Collating/Stuffing Copying Encoding Faxing Filing Folding Machine General Office Good Handwriting Inside Sales Insurance Claims Inventory Inverted Keyboard Mailroom Microfiche Outside Sales Payables Payroll Postage Machine Posting Purchasing Receivables Supply Ordering

Electronic Assembly	None Ansi Balancing Blueprints Cables Calibration Centering Clean Room Coaxial Color Code Components Diagnostics Disassembly Final Electronic Assembly QC Fine Pitch Harness ISO 9000 Mechanical Assembly Microscope PC Board Touch Up Plugs Printed Circuit Boards Re-Work Schematics Soldering Stuffing Surface Mount Testing Visual Inspection Wire Wrap Wiring

Languages	English Chinese French German Hmong Italian Japanese Korean Laos Russian Spanish Spanish ONLY Thai Vietnamese

Light Industrial	None Order Pulling Courier Distribution Environment Dock Work FedEx Forklift General Warehouse Inventory Labeling Laminating Machines Load Trucks - 50lbs Packing Parts Department Quality Control Retail Warehouse Scanning/Electric Gun Shipping Receiving Shrink Wrap Software Stockroom Unload Trucks - 50lbs UPS

Mechanical	None Assembly Automotive Parts Dept Auto Paint Body Blueprint Electronic Assembly Injection Molding Maintenance Manual Dexterity Power Tools Schematics Tool & Die

Production	None Aluminum Extrusion Exp Assembly Line Exp Clean Room Lift 10-20 lbs Lift 25-50 lbs Mfg Production Environment No Lifting Packing Dry Goods Packing Medical/Drugs Production Re-Work Sanitation Clean Room Soldering Weighing/Mixing Ingredients

Job Types	Account Executive Account Information Clerk Administrative Asst Administrative Clerk Advertising Clerk Analyst Art Director Assembler AutoCad Broadcast Operator Buyer Buyer Assistant Buyer Senior CAD Operator Call Center Rep Case Manager Cast Sanding Operator Chemist Claims Clerk Claims Examiner Claims Processor Clean Room Technician Clerk Clinical Research Associate	Select the position titles that most accurately describe your current experience and qualifications:

Industries you have worked in	Accounting/Bookkeeping Advertising/Marketing Aerospace Agriculture Amusement/Recreation Architectural Services Armed Services Automotive Repair & Services Banking Beverages Biotech Business Services Construction Consulting CPA Credit/Collection Defense Distribution Educational Services Electronics Employment Services Engineering Environmental/Waste Mgmt Financial Services Fishing Food Processing Forestry Gambling Government/Public Administration Health Services Hospital/Clinic Hotels & Lodging Import/Export Insurance Leasing Legal Services Management Manufacturing Mining Mortgage Museums & Art Non-profit Oil & Gas Pharmaceutical Printing Property Mgmt Publishing Radio/TV Real Estate Repair Services Research Services Restaurant Retail Security & Commodity Software/Computer Services

Recent Employer		Please enter your most recent employer.

Recent Employment - Job Title

Recent Employer's Address

Recent Employer's Phone

Recent Employment Start Date

Recent Employment End Date

Recent Employment Starting Salary

Recent Employment Ending Salary

Recent Employment Supervisor

Recent Employment Reason for Leaving

Recent Employment Job Description

Recent Employment Contact Availability	Yes No	Please indicate if we can or can not contact your recent employer.

Have you ever been terminated or asked to resign from any job?	Yes No

If yes, please explain

Please explain any gaps in your employment history

Ever convicted of a misdemeanor or felony?	Yes No	Have you ever been convicted of a misdemeanor or felony? A "conviction" includes a plea, verdict or finding of guilt regardless of whether sentence was imposed by the court. (Do not include: (1) minor traffic infractions; (2) convictions related to mariju

If yes, please explain

Can you, after employment, submit verification of legal right to work in the U.S.?	Yes No

Have you ever worked for Achieve Employment	Yes No

If yes, please give dates and position

If hired, would you have adequate transportation to and from work?	Yes No

Agree to terms *		I agree to conform to the rules and regulations of the Company, and expressly agree and understand that, if employed, my employment is for an unspecified term and is at will. This means that either I or the Company can terminate the employment relationshi