Candidate Application

Personal Information:
First Name:
Home Phone:
Middle Name:
Work Phone:
Last Name:
Cell Phone:
Nick Name:
Email Address:
Social Security Number:
 
Mailing Address:
 
City:
 
State:
 
Zip Code:
    

How did you hear about SFR? 
Internet/Website:
  
Referral:
 
Other:
 
Are you legally eligible to work in the United States?
 Yes
No
Are you over 18 years of age?
  
Yes
No
Do you have a valid driver's license?
  
Yes
No
Have you ever been convicted of a felony? (A conviction will not necessarily disqualify you for employment) Yes
No
If yes, please explain:  

Have you ever been fired or asked to resign from a job?
Yes
  No
If yes, please explain:  

On what date would you be available to begin work?

Please list any academic honors, scholarships, offices held, etc.
(Please exclude activities which indicate race, religion, gender, national origin, age, disabilities or veteran status.)

Education:
High School
  
Name of School, City and State Location:
 
Major/Degree:
 
Grade Point Average:
  
Graduation Date:
  
Technical, Junior or Community College
  
Name of School, City and State Location:
Major/Degree:
Grade Point Average:
Graduation Date:
University or College
  
Name of School, City and State Location:
 
Major/Degree:
 
Grade Point Average:
  
Graduation Date:
  
Graduate School
  
Name of School, City and State Location:
 
Major/Degree:
 
Grade Point Average:
  
Graduation Date:
  

Certifications:
Certifications Held Credentialing Organization Date of Cert.
Number
Expiration

Computer Application Experience:
Applications Version
Beginner
Intermediate
Advanced

Availability:
 Days Available to Work
  Hours available to work    
Monday   Between 8:00am and 6:00pm
Tuesday   Overtime
Wednesday   Overnight Travel  
Thursday   Extended and Weekend Travel  
Friday   Flexible Schedule Desired  
Saturday        
Sunday

Employment History:
(Begin with current or most recent employer.  Do not exclude any employment.  Include any applicable temporary employment.)

Company Name
Dates Employed
Describe Your Duties

Address
From
To
   
Job Title
Salary
 Telephone Number
Starting
Final
       
Reason For Leaving and Explanation     Name and Title of Supervisor
   

Company Name
Dates Employed
Describe Your Duties

Address
From
To
   
Job Title
Salary
 Telephone Number
Starting
Final
       
Reason For Leaving and Explanation     Name and Title of Supervisor
   

Company Name
Dates Employed
Describe Your Duties

Address
From
To
   
Job Title
Salary
 Telephone Number
Starting
Final
       
Reason For Leaving and Explanation     Name and Title of Supervisor
   

References:
(List four people who are not related to you that supervised your work, who can provide professional references.)
Name Company Name Phone Number Occupation/Relationship Years Known

PLEASE READ CAREFULLY BEFORE SUBMITTING
I hereby certify that all of the information provided by me in this application (or any other accompanying or
required documents) is correct, accurate and complete to the best of my knowledge. I understand that the
falsification, misrepresentation or omission of any facts in said documents could be cause for denial of employment
or immediate termination of employment regardless of the timing or circumstances of discovery. I understand that
submission of an application does not guarantee employment.

I hereby authorize any and all schools, former employers, references, courts and any others who have information
about me to provide such information to South Florida Recruiters and/or any of its representatives, agents or
vendors, and I release all parties involved from any and all liability for any and all damage that may result from
providing such information.

BY CLICKING BELOW, I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE
STATEMENTS.

SOUTH FLORIDA RECRUITERS INC. IS PROUD TO BE AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED
APPLICANTS WILL RECEIVE CONSIDERATION WITHOUT REGARD TO RACE, COLOR, RELIGION, GENDER,
NATIONAL ORIGIN, AGE, DISABILITY, VETERAN STATUS OR ANY OTHER STATUS PROTECTD BY LAW.