Position Applying For:

Customer Service Representative     Pressman
Bindery Operator                               Pre-Press Technician

Date:

-- mm/dd/yy

Personal Information:

Full Name
Date of Birth	mm/dd/yy

Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

Alternate Phone:

Are you at least 18 years of age?

Yes No

Can you, after employment, submit proof of age?

Yes No

Can you verify your legal rights to work in the U.S. by providing appropriate documentation? (if offered employment, proof of U.S. citizenship or the right to work in the United States will be required.)

Yes No

Have you ever been convicted of a felony?

Yes No

Note: A conviction will not necessarily disqualify you from the position from which you have applied.

If YES, please provide the date of the offense, and explain the nature and the result of the conviction.

Emergency Contact:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone

Preferences

Enter the date available for work:

-- mm/dd/yy

Salary Desired:

What days and hours are you available for work?

Are there any hours, shifts, or days that you cannot or will not work?

Yes No

If YES please explain:

Education / Certificates / Training

High School / GED:

School
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone

Business / Trade / Technical:

School
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone

University / College:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone

Other training and or skills related to the position applying for:

List any other education, training, special skills, certifications, or license that you possess:

Employment Record

Are you currently employed?

Yes No

Employment Record: List your employment history.

Begin with your current or most recent employer.

Employment Information 1:

Supervisor's Name
Title
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Alternate Phone

Start Date:

-- mm/dd/yy

End Date:

-- mm/dd/yy

Starting Salary:

Ending Salary:

Summarize the nature of the work performed and job responsibilities:

Reason For Leaving:

May we contact your supervisor?

Yes No

Employment Information 2:

Supervisor's Name
Title
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Alternate Phone

Start Date:

-- mm/dd/yy

End Date:

-- mm/dd/yy

Starting Salary:

Ending Salary:

Summarize the nature of the work performed and job responsibilities:

Reason For Leaving:

May we contact your supervisor?

Yes No

Employment Information 3:

Supervisor's Name
Title
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Alternate Phone

Start Date:

-- mm/dd/yy

End Date:

-- mm/dd/yy

Starting Salary:

Ending Salary:

Summarize the nature of the work performed:

Reason For Leaving:

May we contact your supervisor?

Yes No

Professional References

Please provide at least three (3) work references who are not related to you in addition to those indicated above

Reference 1

Name
Title
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Alternate Phone
E-Mail

Reference 2:

Name
Title
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Alternate Phone
E-Mail

Reference 3:

Name
Title
Company
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Alternate Phone
E-Mail

Read and Sign

I authorize One Stop Printing Inc. to conduct a reference and a background investigation, which may include driving record, criminal record, credit, and educational background and professional license. I understand and agree that employment may be contingent upon the results of the reference checks and the background investigation.

I understand I will be required to provide information for compliance with the Immigration Reform and Control Act. I understand that I may be required to have a physical examination, drug test, and pre-employment evaluations.

I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked by One Stop Printing Inc. unless I have indicated to the contrary. I authorize the references listed above to provide One Stop Printing Inc. any and all information  concerning my previous employment and any pertinent information that they may have. Further, I release all parties and person from any and all liability for any damages that may result from furnishing such information by the company or any of its agents, employees, or representatives. I understand that any misrepresentations, falsification, or material omission of information of this application may result in my failure to receive an offer, or if I am hired, in my dismissal from employment.

In consideration of my employment, I agree to conform to the rules and standards of One Stop Printing Inc. and agree that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at anytime, either at my option or at the option of One Stop Printing Inc.

Entering my initials in the space below, acknowledges that I understand and accept the above statements.