Test Form - The Bettinger Co., Inc.

I AGREE

Personal Information

FULL NAME: First, Middle Initial, Last:

First

Middle

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Cell/Mobile Number

Alternate Phone Number?

Email

Emergency Contact Phone Number

Emergency Contact Name and Relationship

Position Applying for:

How Did You Hear About The Bettinger Company?

If you selected 'Other' above, please describe how you heard about us.

I am interested in:

Full-time work
Part-time work

Resumé attached to this application?

Yes
No

Salary Requirements/Minimum Rate

Preferred Work Location:

Mode of Transportation

Car
Public Transportaion
Both

Do you have a Driver's License?

Yes
No

State Where Issued and License Number

Are you eligible to work in the U.S.?

Yes
No

Please provide your U.S. Alien Registration Number or other explanation::

Have you ever been bonded?

Yes
No

Are you eligible to be bonded?

Yes
No

Being bonded means having an insurance policy in which the effort of the bonded company is guaranteed against problems.

Is there is any reason that you would be unable to fulfill all the responsibilities of the position for which you are applying?

Yes
No

If yes, please explain here:

EDUCATION

Name of High School

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Attended from:

Attended to:

Did you graduate?

Yes
No

Degree obtained

High School Diploma
General Educational Development (GED)
No Degree Obtained

Name of College/University

Address

Address Line 1

Address Line 2

City

State

Zip Code

Attended from:

Attended to:

Did you graduate?

Yes
No

Degree obtained

Subject/Major

EMPLOYMENT HISTORY

Most Recent/Current Employer

Address

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone Number

From:

To:

Position Title

Name of Supervisor

Reason for Leaving

Previous Employer

Address

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone Number

From:

To:

Position Title

Name of Supervisor

Reason for Leaving

OTHER SERVICES

If you have worked for a Temporary Help Service in the past, please complete the section below. If you have not worked for such a service, please enter NA.

Name of Company

Location of Position

Position Held/Title

Assignment Dates: To/From

Name of Company

Location of Position

Position Held/Title

Assignment Dates: To/From

PLEASE PROVIDE THE NAMES/ADDRESSES OF TWO PREVIOUS EMPLOYMENT REFERENCES:

Name of First Reference

First Reference Title/Position

First Reference Phone Number

First Reference Company Name

First Reference Address

Address Line 1

Address Line 2

City

State

Zip Code

Second Reference Phone Number

Name of Second Reference

First

Last

Second Reference Title/Position

Second Reference Company Name

Second Reference Address

Address Line 1

Address Line 2

City

State

Zip Code

RESUME SUBMISSION

File Upload

Click or drag a file to this area to upload.

Please submit my application to: *

Personal Information

EDUCATION

EMPLOYMENT HISTORY

OTHER SERVICES

PLEASE PROVIDE THE NAMES/ADDRESSES OF TWO PREVIOUS EMPLOYMENT REFERENCES:

RESUME SUBMISSION

Copyright 2021 The Bettinger Co., Inc.