Application

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Date*

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Job Title

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Job Listing

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Job Listing ID

Shift Desired

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First Shift
Second Shift
Third Third Shift

Location you are applying for

Owensboro, KY
Bowling Green, KY
Clermont, FL
Orlando, FL
Evansville, IN
Hopkinsville, KY
Elizabethtown, KY
Hartford, KY
Louisville, KY

Have you ever been placed for employment with 323 Staffing Solutions?*

No
Yes

Where and When?

Personal Information

Name*

First Middle Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone*

Home Phone

Email Address*

Educational Information

Schools

School Name

Address

City State / Province / Region ZIP / Postal Code Country

Graduate

Yes
No

Degree

Diploma, GED, Certificate

Are you currently enrolled?*

Yes
No

Explain

Employment History

Employers

Name of Employer

Employer's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

From

To

Job Title

Full-Time
Part-Time

Job Duties

Supervisor's Name

Supervisor's Contact Number

Reason for Leaving

Begin with your present or last job

Please select your computer skills or experience

Microsoft Office
Spreadsheets
Quickbooks
Email
Powerpoint Presentations
Database
Social Media
Web
Graphic Design

Please list all of your experience in handling and operating trade related equipment

Please select your skills

Describe your other skills

Additional Information

What type of employment are you seeking?

Full-Time
Part-Time

What hours are you seeking?

When can you begin work?*

Are you legally authorized to work in the United States?

Yes
No

Do you possess a valid drivers license?

Yes
No

Do you have an official social security card?

Yes
No

Do you have reliable transportation?

Yes
No

Have you ever been discharged or forced to resign for misconduct or unsatisfactory work at your job?

Yes
No

Please explain

Have you been convicted of a crime other than a minor traffic violation?

Yes
No

Charges

Charge

Location

City State / Province / Region ZIP / Postal Code Country

Date

Current Status

Would you pass a drug test administered by 3:23 Staffing Solutions?

Yes
No

Professional References

Please do not use family or friends.

References

Name

First Last

Phone Number

Job Title

Years Known

Please enter a number greater than or equal to 0.

CERTIFICATE OF APPLICANT - READ BEFORE SIGNING*

I acknowledge that 3:23 Staffing Solutions, LLC is a Christian based organization and should I be hired I am required to participate in a mandatory drug test. I also certify that all statements on this form are true, accurate and completed by my own hand. Any misrepresentations or omission of facts may result in my being disqualified for employment, or if hired, terminated from employment.

I understand that routine inquiry or investigation may be made during the initial or subsequent processing to provide information applicable to the job for which I am applying. I herby grant 3:23 Staffing Solutions, LLC. permission to access those records they deem necessary and release all parties from liability. I understand the information on this form will be treated in a manner consistent with the beliefs and business needs of 3:23 Staffing Solutions, LLC. and the laws of the state of Kentucky.

I further understand that I am applying for work through a temporary staffing company and 3:23 Staffing Solutions, LLC. reserves the right to terminate my employment at any time. As a temporary employee with 3:23 Staffing Solutions, LLC. I will not be entitled to annual or sick leave, paid holidays, health or dental insurance, grievance rights or other benefits normally associated with permanent employment.

I agree to the terms.

3:23 Staffing Solutions, LLC. is committed to a policy of equal employment opportunity and affirmative action. 3:23 Staffing Solutions, LLC's commitment is firm and long-standing. In keeping with this policy 3:23 Staffing Solutions, LLC will recruit, hire, train, promote, transfer and terminate persons without regard to race, color, religion, national origin, age, sex, gender, pregnancy, disability, sexual orientation, gender identity, genetic information, military status, veteran status (specially status as a disabled veteran, Vietnam Era Veteran recently separated veteran, armed forces service medal veteran, or other protected veteran status), or other classification protected by applicable federal, state, or local law, except where age or sex is a bona fide occupational qualification. In addition, 3:23 Staffing Solutions, LLC will ensure that all other personnel actions such as compensation, benefits, will; be administered without regard to race, color, religion, national origin, age, sex, gender, pregnancy, disability, sexual orientation, gender identity, genetic information, military status, veteran status (specially status as a disabled veteran, recently separated veteran, armed forces service medal veteran, or other protected veteran status), or other classification protected by applicable federal, state, or local law.

323 Staffing Solutions

Personal Information

Educational Information

Employment History

Additional Information

Professional References

“Whatever you do, work at it with all your heart, as working for the Lord, not for man.”

Owensboro, KY

Bowling Green, KY

Winter Garden, FL

Elizabethtown, KY

Louisville, KY

Hopkinsville, KY

Evansville, IN