General Ledger Resources

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Personal Information

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Social Security Number:

Home Phone:

Work Phone:

Cell Phone:

E-mail Address:

Minimum salary requirement for temporary or contract assignments:

Availability

Please mark availability:

Full Time Part Time

Date available for work:

Have you ever pled guilty or "no contest" to, or been convicted of a felony or misdemeanor:

Yes No
If yes, please explain

Can you, after employment, submit verification of your legal right to work in the U.S.?

Yes No

Education

Mark your highest level of education:

HS Diploma or GED
College Degree/BA or BS
MBA
Accounting/Finance Degree
AA Degree
CPA
Ph D.
Masters Degree

Name of school:

Address:

Number of years attended:

Degree(s) (BA/BS/MBA) Major:

Employment History

Have you ever been terminated or asked to resign from any job?

Yes No
If yes, please explain

Please list any companies that you previously worked for on a temporary basis:

Dates:	Company:	Supervisor:	Phone:	Duties:

May we contact your current employer?

Yes No

Please complete the following employment history even if we already have a resume on file.

Employer 1

Company Name:

Type of Business:

Street Address:

City:

State:

Zip:

Duties:

Dates employed:

Reason for leaving?

Supervisor's name:

Phone Number:

Employer 2

Company Name:

Type of Business:

Street Address:

City:

State:

Zip:

Duties:

Dates employed:

Reason for leaving?

Supervisor's name:

Phone Number:

Employer 3

Company Name:

Type of Business:

Street Address:

City:

State:

Zip:

Duties:

Dates employed:

Reason for leaving?

Supervisor's name:

Phone Number:

References

Please list a minimum of two references that we may speak to on your behalf.

Reference 1

Name:

Phone Number:

Company:

Nature of Relationship:

Reference 2

Name:

Phone Number:

Company:

Nature of Relationship:

Reference 3

Name:

Phone Number:

Company:

Nature of Relationship:

Submission

I certify that my answers are true and correct to the best of my knowledge. I authorize General Ledger Resources to verify all information. I understand that certain positions may require a background check, drug/alcohol screen, and/or credit investigation, and I authorize such as deemed necessary. I hereby release General Ledger Resources from any liability associated with requesting or receiving information in connection with my application.
IF YOU AGREE, PLEASE CHECK :