Full Name *

Present Street Address *

City *

State *

Zip Code *

Phone Number *

Alternate Phone Number

Date of Birth *

Email Address *

Are you prevented from lawfully becoming employed in this country because of VISA or immigration status? *YesNo

Employment Desired (Position) *

Date you can start *

Salary Desired *

Are you employed now? *YesNo

If so, may we inquire of your present employer?YesNo

If your answer is yes, give name and contact information for your present employer

Who referred you to Quality Tool Service, Inc.?

High School Name

Did you graduate?YesNo

What year?

Subjects Studied

College

Number of years?

Did you graduate?YesNo

What year?

Subjects Studied

General Subjects of Special Study, Special Skills, Activities or Special Interest

EMPLOYMENT HISTORY - Former Employers (List the last three employers, starting with the last one first)

Employer #1 (most recent)

From

To

Employer Address

Salary

Position and Responsibilities

Reason for Leaving

Employer #2

From

To

Employer Address

Salary

Position and Responsibilities

Reason for Leaving

Employer #3

From

To

Employer Address

Salary

Position and Responsibilities

Reason for Leaving

REFERENCES - Give the names and phone numbers of three persons not related to you, whom you have known at least one year.

Reference #1

Reference #1 Phone Number

Reference #2

Reference #2 Phone Number

Reference #3

Reference #3 Phone Number

Date

Signature (by typing your name you are agreeing the information above is true and complete) *

3 + 1 = ?Please prove that you are human by solving the equation *